Anthracycline-induced cardiotoxicity (AIC) remains a significant clinical challenge in oncology, threatening long-term cardiac function in patients receiving these potent chemotherapeutic agents. Recent discoveries underscore multiple pathogenic mechanisms—including oxidative stress, ferroptosis, pyroptosis, and necroptosis—that collectively drive myocardial injury. Early detection methods, such as speckle-tracking echocardiography and cardiac biomarker analysis, have enhanced clinicians’ ability to identify subclinical changes. Concurrently, various cardioprotective strategies—ranging from dexrazoxane and liposomal formulations to dietary interventions and emerging cell death inhibitors—offer promise in mitigating AIC without compromising antineoplastic efficacy. This chapter delves into the core molecular pathways involved in AIC, reviews both established and emerging strategies for early diagnosis, explores critical risk factors, and provides a detailed discussion of traditional and novel management approaches. By integrating pharmacological agents, nutrition and lifestyle modifications, and interdisciplinary collaboration, clinicians can optimize patient outcomes and safeguard cardiac health in the face of anthracycline therapy.