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Pegunigalsidase alfa is a recombinant enzyme replacement therapy designed to treat patients with Fabry disease, a rare genetic disorder caused by a deficiency of the enzyme alpha-galactosidase A. This deficiency leads to the accumulation of globotriaosylceramide (Gb3) in various tissues, which subsequently causes progressive damage to the kidneys, heart, and nervous system. Fabry disease is primarily caused by mutations in the GLA gene located on the X chromosome, affecting predominantly males while also presenting in females, who may experience milder symptoms. Patients with this condition typically begin to exhibit symptoms in childhood or early adulthood, including pain episodes known as acroparesthesia, which can manifest as burning or tingling sensations in the extremities. Additional symptoms may include angiokeratomas, which are small, dark red spots on the skin, as well as gastrointestinal issues, such as abdominal pain, diarrhea, and nausea. Moreover, involvement of the kidneys may result in proteinuria and eventual renal failure, while cardiac manifestations can lead to arrhythmias and hypertrophic cardiomyopathy. Neurological symptoms can also occur, ranging from headaches to more severe complications like stroke. The cumulative effects of these symptoms often significantly impair a patient's quality of life. Pegunigalsidase alfa works by providing a sustained release of the enzyme into the bloodstream, promoting enhanced clearance of Gb3 from the body, and potentially alleviating the debilitating symptoms associated with this disorder. Clinical studies have shown that patients receiving pegunigalsidase alfa experience improvements in kidney function and reductions in Gb3 storage in various tissues, leading to a better overall prognosis. Moreover, this therapy is administered via intravenous infusions and may be tailored to each patient's needs in terms of frequency and dosage. Ultimately, pegunigalsidase alfa represents a significant advance in the management of Fabry disease, aiming not only to address the enzyme deficiency but also to mitigate the adverse effects on multiple organ systems, thereby enhancing the quality of life for those affected. It is essential for patients to engage closely with their healthcare providers to monitor for potential side effects and to evaluate the therapy's effectiveness regularly, ensuring optimal treatment outcomes as part of a comprehensive management plan for Fabry disease.