Palatal impaction of the maxillary canine continues to present a significant clinical challenge in orthodontics because of its multifactorial origin, variable clinical presentation, and close anatomical relationship with adjacent teeth. If left undetected, the condition may lead to complications such as external root resorption, periodontal tissue breakdown, prolonged orthodontic treatment, and compromised esthetic and functional outcomes. This narrative review provides a comprehensive overview of the current understanding of palatally impacted maxillary canines, focusing on their etiology, diagnosis, classification, and available treatment options. The importance of early clinical recognition and appropriate radiographic assessment is highlighted, as timely intervention can simplify treatment and improve prognosis. Contemporary management strategies, including interceptive procedures, surgical exposure with orthodontic traction, autotransplantation, and extraction in selected cases, are discussed together with the indications, benefits, and limitations of open and closed surgical techniques. Recent developments in cone-beam computed tomography, skeletal anchorage, and orthodontic biomechanics have enhanced diagnostic accuracy and improved treatment predictability. Successful management requires careful treatment planning based on patient age, stage of root development, position of the impacted canine, and associated pathology. An interdisciplinary approach involving orthodontists, oral surgeons, and restorative clinicians remains essential for achieving stable functional outcomes while preserving periodontal health and facial esthetics.