Although originally developed as a tool to help people quit smoking, e-cigarettes rapidly became a popular method for consuming nicotine and delta-9-tetrahydrocannabinol (THC) worldwide. In 2019, a new health risk emerged: e-cigarette or vaping product use-associated lung injury (EVALI). Primarily seen in the United States, with fewer cases globally, the pathophysiology of EVALI remains largely unknown. Although research has implicated the aerosolisation of harmful chemicals like vitamin E acetate, aldehydes, and heavy metals as potential contributors to lung injury, no definitive cause has been established. This review consolidates current knowledge about EVALI, focusing on its epidemiology, clinical presentation, and management. Most cases involve young adults, raising concerns over flavoured products and aggressive marketing targeting youth. Diagnosis relies on a history of recent vaping, respiratory symptoms, imaging, and laboratory findings. Treatment primarily involves supportive care. Limited understanding of the long-term effects of EVALI highlights the need for ongoing research and enhanced regulation. The dual role of e-cigarettes as both a harm-reduction tool for smokers and a potential new source of nicotine addiction complicates public health efforts. This review underscores the necessity of stringent product oversight, targeted prevention strategies, and continued investigation into vaping-related health risks to better protect users.