Neonatal Alloimmune Thrombocytopenia (NAIT) is a rare but potentially life-threatening condition in which maternal alloantibodies target fetal platelet antigens, leading to severe thrombocytopenia, bleeding complications, and, in some cases, intracranial hemorrhage (ICH) or fetal demise. This review provides a comprehensive exploration of NAIT’s pathophysiology, immunologic mechanisms, genetic predispositions, clinical manifestations, diagnostic approaches, and evolving prevention and treatment strategies. Special emphasis is placed on the immunogenetic triggers, particularly Human Platelet Antigen (HPA) incompatibilities, and their population-specific prevalence. Diagnostic techniques such as MAIPA and HPA genotyping are highlighted alongside current antenatal interventions, including intravenous immunoglobulin (IVIG), corticosteroids, and antigen-negative platelet transfusions. Advances in population-based screening, noninvasive fetal genotyping, and consensus guidelines have significantly improved outcomes, reducing ICH rates and enhancing survival. Despite these advances, long-term neurodevelopmental sequelae remain a concern, even in nonhemorrhagic cases. This review integrates recent epidemiologic and clinical findings from 2023 to 2025, emphasizing the growing importance of early recognition, targeted management, and international consensus in improving care for NAIT-affected neonates and future pregnancies.