Vagina is one of the crucial parts of the female reproductive system and is often afflicted by various diseases. Vulvovaginal candidiasis (VVC) is the most common disease caused by Candida species. VVC affects nearly 75% of women at least once in their lifetime and exhibits a high recurrence rate. Current firstline treatments for VVC include antifungal agents such as azoles, polyenes and echinocandins. Emerging therapies like herbal remedies, probiotics and immunotherapeutic vaccines are also available, with azoles being the most commonly used. While effective, these therapies are often limited by drawbacks, including resistance development, adverse effects and suboptimal therapeutic outcomes. Conventional forms of dosage, such as creams, tablets and intravenous infusions, have shown limited success in addressing the complexity of VVC, particularly biofilm formation, which impedes therapeutic efficacy. To overcome these challenges, novel drug delivery systems (NDDS) are being explored, including lipid-based carriers, inorganic nanocarriers, microneedles, nanofibers and in situ gels, which offer enhanced drug delivery and improved bioavailability. Additionally, polymers used in vaginal drug delivery have shown potential in improving the stability and release profiles of formulations. In this review, a comprehensive overview of the pathophysiology and therapeutic strategies has been provided, along with recent advancements in novel drug delivery systems. It highlights their potential and ability to overcome current therapeutic challenges and pave the way for more effective and patient-friendly management of the condition.