Nanophthalmos is an uncommon developmental ocular disorder characterized by a diminutive eye resulting from impaired growth, which may occur sporadically or within familial contexts. Both environmental and genetic factors are implicated in the induction of nanophthalmos. The ocular biometric characteristics associated with nanophthalmos include reduced ocular axis, shallow anterior chamber, thickened scler and microcornea, which may lead to complications such as secondary uveal effusion syndrome and angle-closure glaucoma, as well as comorbidities like congenital cataract. Typically, the diagnosis of nanophthalmos is primarily reliant on the measurement of axial length via ultrasound. This review provides a comprehensive overview of the etiology, clinical manifestations, diagnostic criteria, and therapeutic approaches related to nanophthalmos.