The advancements in intensive care since the mid-20th century have significantly increased survival rates following traumatic and anoxic brain injuries. However, this progress has also led to a rise in cases of Disorders of Consciousness (DOC), including Vegetative States (VS) and Minimally Conscious States (MCS), which present substantial neurological and care challenges. This paper provides an overview of the epidemiology, diagnostic criteria, and management strategies for these conditions, alongside ethical considerations. The incidence of vegetative states is estimated at 0.7–1.1 per 100,000 individuals, with prevalence at 2.5–3.5 per 100,000. While traumatic origins account for one-third of cases, non-traumatic causes such as ischemic strokes, encephalitis, and anoxia represent the majority. Current care pathways reveal disparities in rehabilitation access, with younger, trauma-induced cases more likely to receive intensive care compared to older, anoxia-induced cases, despite contrary recommendations from the 2000 Consensus Conference in Modena. Diagnoses of VS and MCS rely on detailed clinical assessments of awareness, behavioral responses, and neurological function. Advances in diagnostic technologies, such as P300 and CNV-like potentials, have revealed that some patients exhibit physiological correlates of emotions and minimal responsiveness, suggesting a working, albeit impaired, brain. Effective acute rehabilitation is crucial and should begin promptly within the first month post-injury. Dedicated units must integrate intensive and sub-intensive care with measures to preserve life, prevent complications, restore circadian rhythms, and support consciousness recovery. Longterm outcomes, while variable, highlight the importance of sustained care programs that ensure dignity and support for both patients and families. Ethical dimensions remain central to the management of these conditions, with a commitment to balancing the refusal of both therapeutic neglect and excessive intervention. National guidelines emphasize equity, solidarity, and the proportionality of treatments while considering the psychological and social burdens on families. As survival rates extend to decades in some cases, this paper calls for ongoing research and policy updates to address the evolving clinical, ethical, and societal challenges posed by DOC.