Penile cancer incidence varies globally, with lower rates in developed countries and higher rates in developing nations. High-quality data for managing penile cancer is lacking. The two most common treatment approaches for penile cancer are surgery and radiotherapy. Traditional amputation surgery, such as total penectomy, often results in significant psychosexual morbidity. There is a trend towards using organ preservation approaches in suitable patients to improve quality of life. These approaches can include organ-preserving surgery or definitive radiotherapy. In centres with expertise, external beam radiotherapy or brachytherapy can provide excellent local control while preserving cosmetic and functional aspects in localized disease. Additionally, adjuvant radiotherapy is recommended for patients with inguinal or pelvic lymph node involvement and extracapsular extension.