Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. Although most cases follow an indolent course, a subset of patients may develop locally advanced or metastatic disease. This review provides a comparative analysis of major national and international guidelines published between 2015 and 2023, aiming to synthesize current treatment recommendations for cSCC. Surgical excision with clear margins remains the treatment of choice for resectable tumors. Mohs micrographic surgery is indicated in high-risk or recurrent lesions, and radiotherapy may be considered for inoperable patients. In advanced stages, anti-PD-1 immunotherapy is the preferred first-line option. The importance of multidisciplinary evaluation and individualized follow-up is emphasized in complex cases. This article is intended to serve as a practical guide for evidence-based clinical decision-making in the management of cSCC.
