Preterm premature rupture of membranes (PPROM) occurs in 3% of all pregnancies and is responsible for around one-third of all preterm births, resulting in more frequent perinatal morbidity and fetal death. Generally, complications of PPROM increase in frequency and severity as gestational age decreases. PPROM has been linked to several risk factors, including PPROM in a previous pregnancy, maternal cigarette smoking, and importantly urogenital tract infections, leading to chorioamnionitis. The role of infection and inflammation in the development of PPROM and subsequent adverse neurological outcomes on the child, both short-term and long-term, has been demonstrated and established in the scientific literature. It is therefore crucial to correctly diagnose the pregnant woman presenting with signs and symptoms of PPROM and have a satisfying management plan. Expectant care vs intervention, the use of tocolytics, the duration of antimicrobial prophylaxis, the timing of prenatal corticosteroids, the use of magnesium sulfate, and the timing of delivery are all topics of intense research and controversy in the management of PPROM. Studies show that antibiotic administration increases the period of latency and improves certain short-term neurological outcomes, such as lowering the rate of abnormal cerebral ultrasound scans prior to discharge from the hospital, but it has no effect on perinatal mortality, preterm births, or long-term neurological outcomes. Furthermore, an agreement on the best antibiotic treatment regimen, mode of administration, and duration has yet to be reached. Antenatal corticosteroids improve infant survival and lowers substantial short-term morbidity, but long-term neurodevelopmental disability is still a challenge. The use of tocolytics as a preventive measure for neonatal morbidity and mortality is still controversial and research on this approach has not been sufficient. There is evidence that the use of Magnesium sulfate is beneficial in terms of neuroprotection and prevention of adverse neurological outcomes. Ultimately, a universal approach to the management of PPROM has yet to be agreed upon by clinicians. Larger-scale, better quality, and more up to date research is still required in order to find the optimal clinical management protocol.