Background: Chronic diarrhea, defined as persistent loose stool lasting at least four weeks, affects a significant portion of the global adult population, with prevalence varying according to region, underlying health conditions, and healthcare access. It has a multifactorial aetiology including infections, inflammatory diseases, malabsorption syndromes, and functional bowel disorders, which pose substantial challenges in both diagnosis and management. The condition can result in malnutrition, dehydration, electrolyte imbalances, weight loss, and long-term complications if untreated. Early diagnosis and systematic clinical evaluation are therefore essential. Objective: This review aimed to analyse the epidemiological characteristics, diverse etiological factors (such as inflammatory bowel disease, irritable bowel syndrome, and malabsorptive disorders), and the underlying pathophysiological mechanisms. Also, to evaluate diagnostic protocols, imaging, and endoscopic evaluations alongside current therapeutic approaches, emphasizing evidence-based strategies to improve patient outcomes. Methods: A literature review was conducted in PubMed, Scopus, and Web of Science. We searched for chronic diarrhea in Egypt, epidemiology, inflammatory bowel disease, irritable bowel syndrome and malabsorption to identify relevant studies published between 2000 and 2024. Articles were selected based on their clinical focus, language (English and Arabic), and relevance to diagnostic and therapeutic challenges. Strict inclusion and exclusion criteria were applied to ensure that the analysis focused on studies pertinent to the multifactorial aetiologies and management of chronic diarrhea. Conclusion: The review confirmed that chronic diarrhea in Egypt is a multifactorial disorder with aetiologies ranging from infectious and inflammatory to malabsorptive conditions.