New radio (NR) positioning in the Third Generation Partnership Project (3GPP) Release 18 (Rel-18) enables 5G-advanced networks to achieve ultra-high accuracy positioning without dependence on global navigation satellite systems (GNSS) with key enablers such as the carrier phase positioning technique, standardized for the first time in a cellular communications standard and setting a new baseline for future generations. In addition, Rel-18 NR supports positioning functionalities for reduced capability (RedCap) user equipment and bandwidth aggregation for positioning measurements. Moreover, the low power solutions are designed for low power high accuracy positioning use cases. Lastly, sidelink based positioning is introduced in Rel-18. This article constitutes a comprehensive treatment of the Rel-18 NR positioning enhancements crucial for the development of next-generation networks.