The lysosomal storage diseases segmentation by application reveals how therapeutic demand is distributed across clinical settings. Enzyme replacement therapy (ERT) dominates, accounting for roughly 58 % of 2023 global sales, driven by long-acting IV formulations for Gaucher and Fabry that require life-long bi-weekly infusions. Substrate reduction therapy (SRT) represents 22 %, preferred for adult Gaucher type 1 patients intolerant to ERT, while oral delivery supports adherence. Hematopoietic stem-cell transplantation (HSCT), 12 %, is mainly used in early-onset Hurler syndrome where neurocognitive benefit outweighs procedural risk. Gene therapy, 5 %, is nascent but accelerated by regulatory fast-track status for BAT-1806 and OTL-200. Symptomatic care—analgesics, anti-epileptics, dialysis—captures the residual 3 %, reflecting multi-disciplinary management rather than disease-modification.