Brimonidine tartrate is a third-generation, highly selective alpha 2 agonist currently available in various formulations and doses to treat ophthalmological conditions. The aim of this article was to review pharmacokinetics, mechanisms, side effects, and updates on clinical use of topical brimonidine. A literature search using the keywords Brimonidine in ophthalmology was performed using PubMed, Google Scholar, and IndMED. We screened titles, keywords and articles describing the use of Brimonidine, selected and reviewed. The clinical application of brimonidine in ophthalmology is extensive. When considering its application in clinical practice, one should be mindful of the indications, risks, and its benefits. In our review, we have noted that topical brimonidine, apart from its routine usage to reduce intraocular pressure, it is a novel therapy used in higher order aberrations, dysphtopsias postrefractive surgery, ocular congestion, to reduce bleeding in ophthalmic surgery, and to treat facial erythema, a dermatological manifestation of rosacea.