Research on behavior seeking to disrupt, deny, or negatively impact the parent–child relationship, sometimes labeled as parental alienation (PA), has burgeoned in recent years. Despite this proliferation, the theoretical and practical conceptualization of PA is still a highly controversial topic, not helped by the potential outpacing of academic knowledge on PA in relation to its application in socio-legal and clinical contexts. Confusion and controversy persist despite several recent reviews seeking to provide clarity on different areas of PA-related discourse (e.g., its effect on alienated children). The current narrative review, therefore, sought to synthesize learnings from those reviews (most of which were published between 2020 and 2022), with subsequently published work, in the most comprehensive and contemporaneous overview of PA to date. As a narrative review, there were no specific inclusion criteria, other than a limitation to English manuscripts and literature from the last 10 years. Snowballing was also utilized, whereby reference lists were used to identify further papers for inclusion. The resulting review outlines current understandings of (a) the key areas of controversy relating to PA, including how it is defined, its use in family court proceedings, and recommendations on intervention; (b) how PA is enacted, by whom, and in what contexts; and (c) how PA impacts on parents, children, and other family members. Crucially, urgent recommendations for further research directions are then made, particularly in relation to legal applications and therapeutic intervention.