Bipolar disorder (BD) and substance use disorder (SUD) usually arise in conjunction, leading to worse outcomes than when either condition exists independently. This co-occurrence is associated with a greater number of severe symptoms, longer illness duration, higher suicide rates, and increased overall health problems. The growing number of individuals affected by both BD and SUD has sparked interest in understanding their connection and finding effective treatment strategies. This research paper provides a comprehensive overview of the high rates of SUD among people with BD. It explores certain determinant factors such as genetic polymorphism, neurobiological implications, and psychosocial and environmental factors that contribute to this association. It also discusses the challenges in diagnosing both conditions, given their overlapping symptomatology, and the importance of recognizing dual diagnosis in clinical settings. Treatment options, including medications, psychotherapy, and integrated care models, are examined, focusing on tailored approaches for patients. The review also touches on the stigma surrounding dual diagnosis, which can affect treatment engagement. Lastly, it highlights the promise of innovative therapies and emphasizes the need for more research to improve detection, medical care, and attention.