Rosacea is a common chronic inflammatory skin disease with a variety of clinical manifestations such as centro-facial erythema, papules and pustules, as well as ocular involvement. Based on these manifestations, rosacea is clinically divided into four subtypes necessitating distinct therapies. Despite recent scientific advances, the pathomechanisms underlying rosacea in general and the different subtypes in particular are still elusive. Accordingly, current treatment options remain mostly broad and symptomatic. In this review we discuss the clinic of rosacea, its impact on the patient, and the pathophysiological mechanisms involved, describe treatment options and highlight differential diagnoses relevant for treating physicians.