As a perennial xerophytic shrub, characterized by plesiomorphic features, the caper (Capparis spinosa L.) is naturally spread throughout the Mediterranean basin and occupies an important ecological role, as well as an economic one, in traditional and specialized systems for commercial production. This species, in spite of its wide diffusion, is currently considered at risk of genetic erosion, mainly due to overgrazing and overharvesting for domestic uses and for trade. This situation is made more serious because of the lack of efficient propagation techniques, determining the caper as a “difficult-to-propagate species”. In this review, we report the main available sexual and vegetative propagation techniques with the aim of assessing whether, and to what extent, this criticality is still true for caper as a horticultural crop. In terms of seed propagation, germination rates have generally been considered quite low or unsatisfactory, and are also affected by hybridization phenomena that are likely to occur among both the wild and cultivated forms. The seeds show a physiological dormancy that can be lowered by adopting hormonal treatments, but in situ germination remains a critical phase. Vegetative propagation appears quite effective, mostly as related to in vitro techniques that allow caper cultivation that is no longer affected by propagation for an economic dissemination of the species in more intensive orchards. The research needs for Caper spinosa L. as a horticultural crop, especially in the field of genetic improvement and breeding, are also underlined.