Hydrangeas, prized for their showy blooms, encompass diverse shrubs, small trees, and climbers within the Saxifragaceae family. This review comprehensively examines various aspects of hydrangea cultivation, focusing primarily on Hydrangea macrophylla. Originating from temperate regions of eastern Asia, eastern North America, and South America, hydrangeas are popular globally, especially as potted plants during festive seasons. Their large flower heads exhibit a range of colors influenced by soil pH, particularly in Hydrangea macrophylla, where aluminum availability in acidic soils (pH 4.5-5.5) results in blue hues, while higher pH (6.0-7.0) produces pink flowers. The review details optimal climatic conditions, including semi-shade and cool, moist temperatures, with specific temperature requirements for flower initiation and bud development. Soil preferences, propagation methods (seeds, cuttings, layering, and micropropagation), planting guidelines, fertilization strategies (including the impact of NPK ratios and slow-release fertilizers), and pest and disease management are discussed. The importance of cultural control methods, such as proper cultivation, fertilization, irrigation, and sanitation in minimizing disease incidence is emphasized. Common diseases like anthracnose, leaf spot, powdery mildew, bacterial wilt, bud blight, and Botrytis infection are described, along with appropriate control measures. The review concludes by highlighting the importance of understanding these factors for successful hydrangea cultivation and production.