Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense pruritus and recurrent eczematous lesions. This review comprehensively examines the emerging role of microneedle (MN) technology in AD management, focusing on its potential to overcome the limitations of conventional topical therapies. We systematically analyze various MN platforms, including dissolving, hydrogel-forming, and coated microneedles, for their ability to enhance drug delivery across the impaired skin barrier in AD patients. The discussion encompasses material selection, design optimization, drug loading strategies, and release kinetics specifically tailored for AD treatment. Furthermore, we evaluate the clinical translation potential of MN systems through analysis of preclinical efficacy studies, safety profiles, and ongoing clinical trials. The integration of MN technology with biologics, small molecules, and natural compounds offers promising avenues for personalized AD therapy with improved efficacy and reduced side effects.