The article reviews the role of matrix metalloproteinases (MMPs) in the development and progression of colitis-associated cancer (CAC), a form of colorectal cancer (CRC) associated with chronic inflammatory bowel disease (IBD). MMPs are zinc- and calcium-dependent endopeptidases that play crucial roles in extracellular matrix degradation, which is essential for tumor expansion, invasion, and metastasis. The authors highlight that while MMPs have been extensively studied in sporadic CRC, their role in CAC is less understood. They discuss the differential expression and activity of MMPs in CAC compared to sporadic CRC, emphasizing the potential of MMPs as biomarkers and therapeutic targets. Key observations include the higher activity of MMPs in early phases of CAC, suggesting that using MMPs as biomarkers for advancing neoplasia and therapeutic targets for adjuvant therapy in advanced stage primary CAC could yield more favorable outcomes. The article also reviews the regulation of MMP activity, the relationship between IBD and CRC, and the potential of MMP inhibitors as therapeutic agents. Despite the challenges in developing effective MMP inhibitors, the authors suggest that further research is needed to understand the pathways through which different MMPs exert their actions and to explore the therapeutic applications of MMP inhibitors in managing IBD and CAC.The article reviews the role of matrix metalloproteinases (MMPs) in the development and progression of colitis-associated cancer (CAC), a form of colorectal cancer (CRC) associated with chronic inflammatory bowel disease (IBD). MMPs are zinc- and calcium-dependent endopeptidases that play crucial roles in extracellular matrix degradation, which is essential for tumor expansion, invasion, and metastasis. The authors highlight that while MMPs have been extensively studied in sporadic CRC, their role in CAC is less understood. They discuss the differential expression and activity of MMPs in CAC compared to sporadic CRC, emphasizing the potential of MMPs as biomarkers and therapeutic targets. Key observations include the higher activity of MMPs in early phases of CAC, suggesting that using MMPs as biomarkers for advancing neoplasia and therapeutic targets for adjuvant therapy in advanced stage primary CAC could yield more favorable outcomes. The article also reviews the regulation of MMP activity, the relationship between IBD and CRC, and the potential of MMP inhibitors as therapeutic agents. Despite the challenges in developing effective MMP inhibitors, the authors suggest that further research is needed to understand the pathways through which different MMPs exert their actions and to explore the therapeutic applications of MMP inhibitors in managing IBD and CAC.