Pharmacogenomics (PGx), the intertwined knowledge of pharmacology and genomics, is well known. Taking PGx in pace with modern sequencing technological advancements is essential for effective clinical utilization, implementation, and personalized treatment care. Molecular profiling is a technique used to analyze the genetic and molecular makeup of an individual's cancer or other diseases. Decisions on a patient's course of treatment, including the choice of an appropriate pharmacotherapy, can be made using this information. For example, molecular analysis can pinpoint genetic changes that increase a patient's propensity to respond to a particular treatment. It can also reveal potential resistance mechanisms, which helps choose effective treatments for patients. In addition, molecular profiling can help to identify possible side effects that a patient may experience when taking certain medications. Overall, molecular profiling can be a valuable tool in helping to optimize pharmacotherapy for an individual patient. This review highlights the history of PGx, the role of pharmacogenes, PGx guidelines, the interrelation between PGx and personalized medicine, PGx technologies, challenges, and solutions in the implementation of PGx, international and national execution of PGx, and PGx in geriatric patient care, pediatric patient care, maternal, fetal medicine, general medicine, and oncology with a focus on the international and national scenarios. This review aims to better elucidate PGx for clinical implementation by healthcare workers, clinicians, and researchers to ensure efficient, safe, and cost-effective pharmacotherapeutic treatment plans for patients.