Advancements in cancer treatment and the consequent increase in post-treatment survival have brought the challenges associated with cancer therapy into sharper focus. Many treatment modalities, such as chemotherapy, are administered systemically, leading to significant systemic side effects. Cognitive impairments, including deficits in executive functions, attention, memory, word finding difficulties, and the inability to acquire new skills, can arise during and after cancer treatment, a phenomenon known as "chemo brain." Post-chemotherapy cognitive impairment can be observed at high rates and may persist long-term in nearly one-third of cases, resulting in a decline in quality of life and functional impairment. Proposed mechanisms underlying the pathophysiology of chemo brain include disruption of blood-brain barrier integrity leading to increased permeability and brain susceptibility, DNA damage and associated deficiencies in DNA repair, telomere shortening, oxidative stress, pro-inflammatory cytokines and neuroinflammation-neurotoxicity, neuronal genetic susceptibility and epigenetic changes, post-chemotherapy hormonal alterations, reactive oxygen radicals and effects, loss of spinal and dendritic arborization, microtubule disintegration, reduced neurogenesis, neurotransmitter alterations, mitochondrial dysfunction, and loss of spinal density. This review aims to evaluate the characteristics, clinical manifestations, pathophysiology, and options for prevention or treatment of chemo brain, accompanied by current literature findings, thereby contributing to the existing body of knowledge.