Concurrent chemoradiotherapy (CRT) followed by brachytherapy is the standard of care for locally advanced cervical cancer. However, post-treatment management remains challenging. Accurate response assessment is essential because it informs subsequent management, particularly the indication for completion surgery. Radiation-induced tissue changes may impair the reliability of clinical examination and conventional imaging, while the respective roles of advanced imaging modalities and completion surgery remain debated. Functional lumbopelvic MRI incorporating diffusion-weighted and perfusion sequences is the reference imaging modality for response assessment and provides greater diagnostic performance than clinical examination alone. FDG PET-CT offers complementary information, particularly regarding nodal disease and early metabolic response, but the routine combination of FDG PET-CT with MRI has not been shown to improve diagnostic accuracy. MRI performed early during CRT may help differentiate responders from nonresponders based on changes in the apparent diffusion coefficient. However, the optimal timing of MRI after treatment completion remains uncertain. Available evidence does not support the routine use of conization for response assessment. Completion surgery provides no prognostic benefit and increases morbidity in patients with squamous cell carcinoma who achieve a complete response after CRT and brachytherapy. Evidence remains insufficient to establish its role in adenocarcinoma. When completion surgery is indicated, delaying the procedure until at least 6–8 weeks after CRT may reduce postoperative morbidity. Simple hysterectomy should be favored over radical hysterectomy, which increases morbidity without improving survival. Current evidence demonstrates no superiority of minimally invasive surgery or laparotomy in terms of oncologic outcomes or overall morbidity.