Autoimmune disorders affect over 5-8% of the global population, arising from loss of immune tolerance and attack on self-antigens. Conventional treatments rely on broad immunosuppression with corticosteroids and DMARDs, which offer symptomatic relief but carry significant toxicity and incomplete remission. Immunotherapy has emerged as a targeted paradigm, aiming to restore immune homeostasis rather than suppress it globally. Understanding its evolution is critical for advancing precision medicine in autoimmunity. To review examines the current status, mechanisms, clinical applications, and future directions of immunotherapeutic approaches for autoimmune disorders. Findings from this study revealed that current immunotherapies include anti-TNF (infliximab, adalimumab), anti-CD20 (rituximab), anti-IL-17 (secukinumab), and anti-BAFF (belimumab) agents, showing 50-70% response rates in RA and SLE. Novel cell-based approaches, particularly CAR-Tregs, low-dose IL-2 therapy, and mesenchymal stem cell transplantation, demonstrate ability to restore regulatory T-cell function and durable tolerance in early-phase trials. Tolerogenic dendritic cell vaccines and antigen-specific immunotherapies are emerging for MS and T1D with reduced off-target effects. However, challenges persist including cytokine release syndrome, high costs, loss of efficacy over time, and risk of opportunistic infections. Biomarker-driven stratification and combination therapies are improving outcomes, with JAK inhibitors and checkpoint agonists showing promise in refractory cases. Immunotherapy is transforming autoimmune disease management from broad suppression to precise immune rebalancing. While biologics remain the mainstay, next-generation cell-based and antigen-specific therapies offer potential for long-term remission and cure. Future progress hinges on identifying predictive biomarkers, reducing costs, and conducting large-scale trials. Integration of omics, AI-driven drug discovery, and personalized tolerance induction will define the next era of autoimmune therapeutics.