This chapter provides an in-depth exploration of pharmacological precision medicine strategies for addressing diverse forms of dementia. It delves into the nuanced treatments available for Alzheimer’s disease (AD), encompassing symptomatic relief through cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists, as well as anti-amyloid therapies. Moreover, it delves into potential disease-modifying avenues like cell and gene therapy, anti-tau interventions, and repurposing medications originally intended for metabolic disorders. In the realm of vascular dementia (VaD), the focus remains on alleviating symptoms via cholinesterase inhibitors and NMDA receptor antagonists, complemented by repurposing cardiovascular drugs to target underlying vascular factors. The chapter also navigates through treatment approaches for dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), addressing symptomatic management, repurposing of other medications, and emerging disease-modifying options that target alpha-synuclein pathology. Furthermore, it delves into the evolving landscape of frontotemporal dementia (FTD) treatment, exploring potential interventions aimed at modifying the disease course by targeting tau and TDP-43 proteinopathies. Emphasizing the pivotal role of personalized medicine in dementia care, this comprehensive review underscores current strategies while also projecting toward future advancements. By tailoring treatments to individual patient profiles and leveraging cutting-edge therapeutic modalities, this paradigm aims not only to improve immediate outcomes but also to enhance overall patient well-being and quality of life in the long term.