Hepatic fibrosis represents a significant global health burden characterized by the excessive accumulation of extracellular matrix proteins in response to chronic liver injury. Despite advances in understanding its pathogenesis, effective therapeutic strategies remain limited. This review examines current therapeutic targets, including antifibrotic agents, cellular pathways (such as TGF-β and hedgehog signaling), and molecular targets (including MMPs and integrins). Limitations of existing therapies, such as efficacy variability and safety concerns, and emerging strategies like novel molecular targets, gene and cell therapies, and combination approaches are discussed. Future directions highlight the potential of personalized medicine, genomics, and innovative drug delivery systems to enhance treatment efficacy and patient outcomes. By addressing these challenges and leveraging ongoing research advancements, this paper underscores the evolving landscape of therapeutic targets in hepatic fibrosis and its implications for clinical practice.