Rhinophyma is a rare, severe manifestation of rosacea marked by progressive nasal thickening due to sebaceous gland hyperplasia and fibrosis. It predominantly affects older men and may cause significant cosmetic and functional impairment. Diagnosis is clinical but may require biopsy to exclude malignancy. Treatment depends on severity and ranges from isotretinoin in mild cases to surgical or laser interventions in advanced disease. This review summarizes the current understanding of its pathogenesis, clinical features, and therapeutic options.