Many theories have been proposed to explain the cause of Peyronie's disease (PD); however, the true pathogenesis of PD remains an enigma. As a result, the treatment of PD remains a dilemma and new therapies continue to evolve. The last two decades have witnessed a phenomenal advance in the understanding of the pathophysiology and natural history of PD. The efficacy of conservative treatment for PD is not settled. In this update review the authors provide information of the status of conservative therapy for PD. Conservative treatment is always the initial treatment in most of the cases. This kind of therapy consists of different modalities of treatment such as oral, intralesional or topical therapy. Other treatments including iontophoresis, extracorporeal shock wave, radiotherapy, ultrasound and laser have also been reported.