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While polypharmacology offers a synergistic therapeutic strategy, the rational design of ligands capable of simultaneously satisfying the geometric constraints imposed by multiple targets remains a major computational bottleneck. This review positions geometric deep learning (GDL) as a powerful integrative approach to overcome these limitations. We systematically survey GDL architectures ranging from invariant graph neural networks to SE(3)-equivariant diffusion models that harness non-Euclidean molecular data to capture intrinsic three-dimensional (3D) structural interdependencies. 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