Aquatic therapy, utilizing the unique properties of water, has emerged as a highly effective modality in physiotherapy. This comprehensive review examines the physiological principles, such as buoyancy, resistance, hydrostatic pressure, and thermal properties, that underpin aquatic therapy. It explores the wide range of indications, from musculoskeletal and neurological conditions to cardiopulmonary issues and specialized care for pediatric and geriatric populations. Various techniques, including Watsu, Ai Chi, Aqua Running, the Halliwick Concept, and the Bad Ragaz Ring Method, are discussed, along with their specific applications and benefits. Evidence-based benefits are highlighted through improved pain management, enhanced functional capacity, and better quality of life outcomes. The implementation and practice of aquatic therapy, including facility requirements, necessary equipment, and therapist training, are outlined. Challenges such as facility costs, patient safety, and therapist availability are addressed. Future directions point towards technological innovations, telehealth integration, and interdisciplinary approaches. Through case studies and clinical examples, the review illustrates the practical applications and effectiveness of aquatic therapy. This review underscores the significant potential of aquatic therapy in enhancing patient care and rehabilitation outcomes, calling for continued research and advancements in the field to maximize its therapeutic benefits