Background: The first evidence of variation from normal in human dentition is usually a noticeable difference in tooth color. Tooth discoloration, a change in natural tooth color, is a common dental finding that is esthetically unpleasant, psychologically traumatic, and socially unacceptable, causing people to seek treatment. This condition affects both children and adults and worsens with age. Aim: The aim of this extensive review is to provide up-to-date information on the types, causes, and clinical features of tooth discoloration that are essential for managing the discoloration. Results: The cause of tooth discolorations is multifactorial and varies in appearance, composition, location, adhesion to tooth surfaces, severity, and treatment. Depending on the cause, tooth discoloration is mainly classified into extrinsic and intrinsic, a combination of both, and intercategory types. Extrinsic stains are deposited on the surface of the outer teeth surfaces. Most chromogenic (color-producing) substances are organic in nature and are found in foods, beverages, tobacco, betel nuts, and chromogenic bacteria. Intrinsic discoloration occurs during tooth development or after tooth eruption and is associated with chemical and structural hard tissue changes. Conclusion: Tooth discoloration presents two challenges for the dentists. The first is to find out the cause of the stain. The second is its management. Tooth discoloration appear in yellow, green, orange, brown, or black, etc., and each color may represent a different origin and the mechanism of staining. Pitting, cracks, and irregularities in tooth enamel can exacerbate discoloration. Clinical significance: This article reviews the etiology and clinical presentation of tooth discoloration. Understanding the cause of discoloration and the physiochemical interaction of chromogens with the tooth surfaces enable dentists to make a correct diagnosis and appropriate treatment. It can also explain to e-patients the nature of the condition and how to prevent it.