Rare and genetic diseases often pose diagnostic and therapeutic challenges, but novel therapies for genetic and rare pediatric diseases are offering renewed hope. Gene therapy, enzyme replacement, antisense oligonucleotides, and mRNA-based interventions are gaining traction for conditions once considered untreatable. Diseases like spinal muscular atrophy, Duchenne muscular dystrophy, and certain metabolic disorders have seen transformative progress with recently approved therapies. Personalized treatment plans guided by molecular diagnostics improve quality of life and long-term prognosis. Multidisciplinary teams work closely with genetic counselors and regulatory bodies to ensure responsible access. As the pipeline for rare disease therapies expands, attention to affordability and global accessibility will be vital to equitable care.