Thoracic outlet syndrome (TOS) is a group of symptoms or disorders caused by compression of the neurovascular bundle, which supplies the upper extremity, due to bony, muscular, or fibrous structures at the thoracic outlet. The clinical presentation of TOS can vary significantly based on the types of neurovascular tissues involved and the locations of compression. The three anatomical spaces associated with TOS are the interscalene triangle, the costoclavicular space, and the subcoracoid space. The three main structures that may become compressed include the brachial nerve plexus, the subclavian artery, and the subclavian vein. Neurogenic TOS is the most common form, accounting for over 90% of all cases, followed by venous, arterial, and traumatic TOS. This condition is more prevalent in females. Diagnostic tools for TOS include ultrasonography, computed tomography angiography, magnetic resonance imaging, and neurological examinations. Conservative management typically consists of physical therapy, lifestyle modifications, and medical treatment. In cases of vascular thrombosis, endovascular procedures such as local thrombolysis and angioplasty, along with anticoagulant therapy, may be considered. Surgical interventions often involve decompression and the removal of aberrant structures, such as a supernumerary cervical rib. Surgical approaches can include supraclavicular, infraclavicular, and trans-axillary incisions, with the trans-axillary first rib resection being the most common decompression procedure. Novel surgeries involve thoracoscopic and robot-assisted procedures. Overall, the therapeutic management of TOS is successful in most cases, and a multidisciplinary approach is essential.