Anal squamous cell carcinoma (SCAC) is a relatively rare malignancy, but its incidence has been rising, largely due to infection with human papillomavirus (HPV), which is the main etiological driver. HPV vaccination and treatment of high-grade squamous intraepithelial lesions (HSIL) significantly lower the risk of progression to invasive cancer, while immunosuppressed individuals face a higher susceptibility to disease development. Most patients are diagnosed with localized SCAC, for which definitive concurrent chemoradiotherapy remains the standard of care, offering high rates of disease control and overall survival Metastatic disease carries a poor prognosis and is primarily managed with systemic therapy with platinum-based chemotherapy is the preferred first-line treatment; recent phase III data established the combination of carboplatin-paclitaxel with retifanlimab (anti-PD1) as a new standard. Ongoing research is focused on HPV-targeted strategies and novel immunotherapies, which hold promise for further improving outcomes in both early and advanced stages of SCAC.