Purpose The Northern Territory (NT) has a unique demographic profile characterised by geographic remoteness, a high burden of comorbidity, and a large Aboriginal and Torres Strait Islander population. There is limited published data describing anal squamous cell carcinoma (SCC) in this jurisdiction. This study aimed to describe the demographic, clinical, and pathological characteristics of anal SCC in the NT. Methodology A retrospective review was conducted of patients diagnosed with anal SCC in the Top End of the NT between 2012 and July 2025 using hospital medical records. Demographic, clinical, pathological, and treatment-related data were collected. Descriptive statistical analysis was performed. Results Seventeen patients were identified. Median age at diagnosis was 68 years, and 76% were female. Aboriginal and Torres Strait Islander peoples comprised 18% of cases, and 29% of patients resided in rural or remote regions. Common presenting symptoms included per rectal bleeding (47%), perianal pain (24%), and an anal mass (24%). Medical comorbidities were present in 71% of patients. High-grade squamous intraepithelial lesions were identified in 24%. p16 positivity was demonstrated in 11 of 12 tested cases. Metastatic disease at diagnosis occurred in 29%. Radiotherapy was delivered to 76% of patients, with treatment-related toxicity documented in 59%. Conclusion This study provides the first description of anal SCC in the NT. Patients commonly presented with significant comorbidity and advanced disease. These findings highlight the challenges of cancer diagnosis and management within geographically remote settings such as the NT.