Individuals with social anxiety disorder (SAD) experience heightened anxiety in interpersonal situations because of their fear of negative evaluation. Given the prevalence of social anxiety in daily life and amidst the current global disasters, additional research is crucial. Recent studies have indicated that changes in self–other referential processing, which combines self-referential and social processing, may align closely with the fear-processing model of SAD. This chapter focuses on the neurobiological basis of social anxiety in the context of self–other referential processing. SAD is associated with limbic system and executive function alterations. The literature also emphasizes distorted self-appraisal and interpersonal bias in social fear, potentially tied to impaired high- and lower-level social cognition, involving empathic accuracy and inflexible attention or perspective shifting. The results underscore the consequences of disrupted self–other processing in SAD, indicating a diminished positive perspective and heightened negative self-impression, reflecting an adverse self-perception through the eyes of others.