Hot melt extrusion (HME) has emerged as a pivotal technology in the pharmaceutical industry, offering a solvent-free, continuous process for producing various drug delivery systems. This technology has gained significant attention due to its ability to enhance the solubility and bioavailability of poorly soluble drugs, develop abuse-deterrent formulations, and create customized drug delivery systems. In this article, we will explore the latest innovations in hot melt extrusion technology, including advancements in equipment, applications, and process analytical technologies.