Background: Arthritis, a collective term for debilitating joint disorders such as rheumatoid arthritis (RA) and osteoarthritis (OA), continues to outpace therapeutic advancements, leaving millions with pain, disability, and limited options. Traditional treatments suffer from non-specific distribution, systemic side effects, and frequent dosing. In this landscape, nanogels—intelligent, stimuli-responsive drug carriers-are redefining the possibilities of precision medicine. By mimicking the body’s soft tissue environment and responding to pathological cues, nanogels hold the promise of delivering drugs exactly where and when they are needed. Methods: This review synthesizes findings across materials science, cellular biology, and pharmaceutical engineering. Recent innovations in nanogel synthesis (e.g., click chemistry, ionic gelation) and drug encapsulation strategies were analyzed alongside in vitro studies using chondrocytes, macrophages, and fibroblast-like synoviocytes. Evaluation metrics included cytotoxicity, cellular uptake, drug release kinetics, and inflammatory cytokine suppression. Key bottlenecks in regulatory translation and manufacturing were critically assessed. Results: Nanogels showcased high biocompatibility, targeted delivery to inflamed tissues, and controlled release triggered by pH, enzymes, or redox gradients within arthritic joints. In vitro, they significantly suppressed pro-inflammatory markers such as TNF-α and IL-6 while maintaining cellular viability. Yet, clinical translation is hindered by scale-up complexity, reproducibility challenges, and limited human data. Conclusion: Nanogels are not merely carriers-they are adaptive, bioinspired systems poised to revolutionize arthritis therapy. With smart design and strategic collaboration across disciplines, these nanostructures could move from lab bench to clinic, ushering in a new era of joint-specific, patient-personalized drug delivery.