Purpose of Review: Pacing-induced cardiomyopathy (PiCM) significantly impacts patient morbidity and mortality, emphasizing the need for improved preventive and therapeutic strategies. This systematic review aimed to evaluate the effectiveness of resynchronization therapies compared to traditional right ventricular pacing (RVP). Recent Findings: Recent studies highlight advancements in therapeutic strategies for PiCM such as biventricular pacing (BiV-CRT) and Hiss-bundle pacing (HPCSP). These techniques improve left ventricular function and clinical outcomes while offering more physiological alternatives by preserving natural ventricular activation. Emerge evidence supports their efficacy in both preventing and managing PiCM. Summary: Both Both BiV-CRT and HPCSP significantly improved cardiac function, with increases in left ventricular ejection fraction (LVEF) and relief of clinical symptoms, as evidenced by improvements in NYHA functional class. Notably, superior benefits of HPCSP over BiV-CRT in QRS amplitude, LVEF, and clinical outcomes was highlighted in two studies. While resynchronization therapies have low complication rates, procedural challenges like venous access and lead placement persist. Additionally, these therapies demonstrate a promising preventive role, particularly in patients with high RVP burdens. Further research is essential to refine treatment strategies and optimize outcomes for PiCM patients.