Since the discovery of the Zika virus in 1947 in Uganda, 70 years have passed, but until the past 10 years, there was little information about the pathogenesis and clinical course of the Zika virus infection. However, in recent years, important changes have occurred in the clinical and epidemiological pattern of the virus. FirstIy it was suggested that the Zika virus might be associated with some neurological disorders, such as Guillain-Barré syndrome (GBS). Then it was suggested that congenital Zika virus infections might be associated with microcephaly and other neurodevelopmental disorders. This new view was initially met with skepticism, but it has been supported by new evidence that strengthens the association between Zika virus infections and GBS, microcephaly, and various neurodevelopmental and ophthalmologic disorders, thanks to the increasing number of case reports and the results of experimental studies. The number of affected people has reached to the millions within the past two years, and the association between Zika virus infections and serious clinical manifestations has caused global concern. As a result of these developments, studies on new treatment alternatives and new vaccine trials is continuing, in addition to discussion of various protective measures. Meanwhile, many studies were conducted to explain the pathogenesis of Zika virus infections. In this review, we present a summary of the current status of Zika virus outbreaks and information on new antiviral treatment options, predominantly protective vaccine trials, and viral pathogenesis.