Leishmaniasis, comprising cutaneous and mucocutaneous forms, is a parasitic disease caused by Leishmania species via sandfly bites, leading to skin ulcers and mucosal damage. Traditional treatments include antiparasitic drugs such as pentavalent antimonials, amphotericin B, and miltefosine, with immunotherapy and chemotherapy being explored for enhanced efficacy and reduced relapse. Mucocutaneous leishmaniasis (ML) balances IFN-γ and IL-10, affecting severity, while cutaneous leishmaniasis (CL) shows varied IFN-γ/IL-10 ratios influencing prognosis. Cytokines and chemokines are diagnostic and prognostic markers in CL. Research into neutrophils and the NLRP3 inflammasome informs Th1/Th2 response regulation. Live attenuated LdCen-/- parasites and genetically modified vaccines show promise, with miR-21 as a potential efficacy biomarker. Understanding cytokine networks is crucial for new treatment strategies.