Human Metapneumovirus (HMPV) is a significant contributor to respiratory tract infections (RTI’s), presenting a clinical spectrum that ranges from mild flu-like symptoms to severe pneumonia. The overlap of clinical features with other RTI’s, often complicates its diagnosis. While HMPV predominately affects young children, the elderly and immunocompromised individuals, its true burden remains under-recognized due to diagnostic challenges. Currently there is no specific antiviral therapy or approved vaccine for HMPV, underscoring the urgent need for research into effective prevention and treatment strategies. Furthermore, the oral manifestations of HMPV infections remains an unexplored domain with potential correlations to viral kinetics and systemic spread. Investigating these oral signs could provide new insights into disease progression and serve as adjunctive diagnostic markers. The present paper provides a comprehensive review of the epidemiology, immunodynamics and diverse clinical manifestations of HMPV, while also shedding light on recent advancements in diagnostic approaches and vaccine development. By addressing these knowledge gaps, future research can pave the way for a more comprehensive approach to mitigate the global burden of HMPV-related respiratory illness