Deutetrabenazine, a deuterated derivative of tetrabenazine, has emerged as an effective treatment for Huntington's chorea and tardive dyskinesia. By selectively inhibiting vesicular monoamine transporter 2 (VMAT2), it reduces the synaptic release of dopamine and other monoamines, thereby alleviating involuntary movement symptoms. Compared to its precursor, deutetrabenazine demonstrates an improved safety profile, with significantly lower incidences of sedation and depression, enhancing patient adherence and suitability for long-term use. It is especially well-tolerated in vulnerable populations such as children and the elderly, showing better emotional stability and pharmacokinetic advantages. While its therapeutic potential is being explored in other neurodegenerative conditions like Parkinson's and Alzheimer's diseases, its current indications remain limited. Long-term administration poses challenges such as drug resistance and mood-related side effects, underscoring the need for psychological monitoring and individualized treatment plans. Furthermore, its high cost and inconsistent insurance coverage constrain global accessibility. Future strategies involving neuromodulation technologies, optimized reimbursement policies, and precision medicine approaches may expand its clinical utility and improve availability worldwide.