Myopia has emerged as a major global public health concern, with rapidly increasing prevalence—particularly among children in East and Southeast Asia. Early-onset myopia is strongly associated with accelerated progression and a heightened lifetime risk of developing high myopia and its sight-threatening complications. A range of behavioural, optical, and pharmacological interventions have been investigated to slow axial elongation and refractive progression. Evidence consistently supports outdoor activity as an effective strategy to reduce the onset of myopia, though its influence on progression remains variable. Near-work and digital device use, may contribute to myopic shifts. Among optical interventions, orthokeratology, multifocal and peripheral-defocus soft contact lenses, and newly developed spectacle lens technologies such as highly aspherical lenslet (HAL) and defocus-incorporated multiple segment (DIMS) designs show clinically meaningful reductions in myopia progression. Pharmacological therapy—particularly low-dose atropine—remains the most effective and widely accepted modality. Emerging therapies, including repeated low-level red-light treatment and biomolecular or genetic-targeted approaches, show promise but require longer-term validation. Myopia control is therefore best approached through individualised, evidence-based combinations of behavioural modification and optical or pharmacologic treatment. Continued research is essential to clarify long-term outcomes, rebound effects, and optimal treatment sequencing to mitigate the global burden of progressive myopia.