Medical-surgical nursing has witnessed significant advancements driven by evidence-based practices (EBP) and technological innovations, improving patient outcomes. This review explores key developments in the field, including Enhanced Recovery After Surgery (ERAS) protocols, multimodal pain management, infection prevention strategies, early mobilization, and patient safety initiatives. The role of electronic health records (EHR), artificial intelligence (AI), telemedicine, and robotic-assisted surgeries in optimizing nursing workflows and patient monitoring is examined. Despite these advancements, staff resistance, resource constraints, and training gaps hinder widespread implementation. Strategies for overcoming these challenges include continuous education, institutional policy changes, and leadership support. Looking forward, personalized medicine, big data analytics, and precision nursing are poised to further revolutionize medical-surgical nursing. To ensure uniform adoption of best practices, standardized guidelines and research-driven protocols must be integrated into clinical practice, fostering safer, more effective, patient-centered care.