The causal relationship between human papillomavirus (HPV) infections and cervical cancer has been extensively documented. Epidemiological studies, supported by molecular technology, have consistently shown that HPV infections are the primary cause of cervical cancer. This association is present worldwide and has been evaluated under all proposed sets of causality criteria. HPV is considered the first identified "necessary cause" of a human cancer. Cervical cancer remains the second most common cancer in women globally, despite being preventable. In developed regions and populations with cytology-based screening programs, adding HPV testing to the screening protocol is beneficial. In areas without efficient cytology programs, HPV testing should be considered as an alternative primary screening method. Prevention through vaccination against high-risk HPV types may be the most effective preventive intervention. Regulatory agencies are urged to evaluate the scientific evidence and consider its implications in terms of costs, public health investments, and policy. The concept of risk groups has been redefined, with persistent HPV carriers identified as high-risk individuals. HPV testing can help distinguish between clinically relevant infections and those unlikely to progress, aiding in screening and patient management. The natural history of HPV infections supports the sexually transmitted nature of cervical cancer, with HPV infections preceding precancerous lesions and cancer by several years.The causal relationship between human papillomavirus (HPV) infections and cervical cancer has been extensively documented. Epidemiological studies, supported by molecular technology, have consistently shown that HPV infections are the primary cause of cervical cancer. This association is present worldwide and has been evaluated under all proposed sets of causality criteria. HPV is considered the first identified "necessary cause" of a human cancer. Cervical cancer remains the second most common cancer in women globally, despite being preventable. In developed regions and populations with cytology-based screening programs, adding HPV testing to the screening protocol is beneficial. In areas without efficient cytology programs, HPV testing should be considered as an alternative primary screening method. Prevention through vaccination against high-risk HPV types may be the most effective preventive intervention. Regulatory agencies are urged to evaluate the scientific evidence and consider its implications in terms of costs, public health investments, and policy. The concept of risk groups has been redefined, with persistent HPV carriers identified as high-risk individuals. HPV testing can help distinguish between clinically relevant infections and those unlikely to progress, aiding in screening and patient management. The natural history of HPV infections supports the sexually transmitted nature of cervical cancer, with HPV infections preceding precancerous lesions and cancer by several years.