Genome editing technologies, particularly CRISPR and its derivatives, have revolutionized molecular biology and medicine by enabling precise and efficient alterations to the genome. This systematic review provides a comprehensive overview of CRISPRCas systems and next-generation genome editing tools, focusing on their therapeutic potentials, challenges, and ethical considerations. Emerging technologies, such as base editing, prime editing, and RNA-targeted CRISPR systems, offer enhanced precision and expanded applications for genetic diseases, cancer therapies, and beyond. However, issues related to off-target effects, delivery mechanisms, and regulatory hurdles remain significant challenges. Ethical debates surrounding germline editing and equity in access to these therapies are also critical considerations that must be addressed. This review synthesizes current advances and explores future directions for genome editing technologies in precision medicine.