This paper aims to review the State of the Art in metal self-expanding stents made from nitinol (NiTi), showing shape memory and superelastic behaviors, to identify the challenges and the opportunities for improving patient outcomes. A significant contribution of this paper is its extensive coverage of multidisciplinary aspects, including design, simulation, materials development, manufacturing, bio/hemocompatibility, biomechanics, biomimicry, patency, and testing methodologies. Additionally, the paper offers in-depth insights into the latest practices and emerging trends, with a special emphasis on the transformative potential of additive manufacturing techniques in the development of metal stents. By consolidating existing knowledge and highlighting areas for future innovation, this review provides a valuable roadmap for advancing nitinol stents.