Natural rubber (NR) and its derivatives play indispensable roles in various industries due to their unique properties and versatile applications. However, the widespread utilization of NR faces intrinsic challenges such as limited mechanical strength, poor resistance to heat and organic solvent, poor electrical conductivity, and low compatibility with other materials, prompting researchers to explore enhancing its performance. Modified NRs (MNRs) like cyclization, deproteinization, chlorination, epoxidation, or grafting NR demonstrated a few enhanced merits compared to NR. However, various strategies, such as blending, vulcanization, crosslinking, grafting, plasticization, reinforcement, and nanostructuring, overcame most drawbacks. This review comprehensively examines these challenges and delves into the modification strategies employed to enhance the properties and expand the applications of NR and its derivatives. Furthermore, the review explores future visions for the NR industry, emphasizing integrating advanced modification techniques, adopting sustainable practices, and promoting circular economy principles. By elucidating the inherent challenges, outlining effective modification strategies, and envisioning future trajectories, this review provides valuable insights for stakeholders seeking to navigate and contribute to the sustainable development of the NR sector.