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Despite the availability of effective prevention strategies, cervical cancer (CC) remains a major global public health challenge. Persistent infection with high-risk human papillomavirus (HR-HPV) is an essential etiological factor in CC, providing an opportunity for screening and monitoring based on specific virological biomarkers. This review summarizes the current evidence on HPV-associated biomarkers in precancerous cervical lesions and cervical cancer, focusing on their role in screening, risk stratification, and patient follow-up. It traces the evolution of screening strategies, from cytology to primary HR-HPV molecular testing and the development of effective triage approaches. Next-generation sequencing technologies have enabled the detailed characterization of HPV genomic integration, highlighting its potential as a diagnostic, prognostic, and predictive biomarker. Additionally, the detection of circulating tumor HPV DNA shows significant promise for refining risk stratification and supporting non-invasive follow-up strategies. Integrating these advanced tools could lead to more efficient triage, personalized therapeutic decision-making, and optimized post-therapeutic monitoring.