Simple Summary: The quality of life of patients with locally advanced cervical cancer (LACC) is impacted by the treatment they receive. The aim of our retrospective study was to evaluate urinary, bowel, and sexual dysfunction in a series of LACC patients who were treated with chemotherapy, radiotherapy, radical surgery, or a combination of these treatments. In a population of 90 LACC patients, we observed an increase in urinary frequency associated with other urinary dysfunction symptoms in the group receiving exclusive radio–chemotherapy. Overall, 57.8% of patients were not sexually active after treatment, and pain was the main reason for avoiding sexual activity. Although the rate and severity of urinary, gastrointestinal, and sexual dysfunction were similar in the four groups, exclusive radio–chemotherapy was associated with worse sexual and urinary outcomes. Background: Different strategies have been proposed for the treatment of locally advanced cervical cancer (LACC), with different impacts on patient's quality of life (QoL). This study aimed to analyze urinary, bowel, and sexual dysfunctions in a series of LACC patients who underwent chemotherapy, radiotherapy, radical surgery, or a combination of these treatments. Methods: Patients with LACC who underwent neoadjuvant radio–chemotherapy (NART/CT; n = 35), neoadjuvant chemotherapy (NACT; n = 17), exclusive radio–chemotherapy (ERT/CT; n = 28), or upfront surgery (UPS; n = 10) from November 2010 to September 2019 were identified from five oncological referral centers. A customized questionnaire was used for the valuation of urinary, gastrointestinal, and sexual dysfunctions. Results: A total of 90 patients were included. Increased urinary frequency (>8 times/day) was higher in ERT/CT compared with NACT/RT (57.1% vs. 28.6%; p = 0.02) and NACT (57.1% vs. 17.6%; p = 0.01). The use of sanitary pads for urinary leakage was higher in ERT/CT compared with NACT/RT (42.9% vs. 14.3%; p = 0.01) and NACT (42.9% vs. 11.8%; p = 0.03). The rate of reduced evacuations (<3 times a week) was less in UPS compared with NACT/RT (50% vs. 97.1%; p < 0.01), NACT (50% vs. 88.2, p < 0.01), and ERT/CT (50% vs. 96.4%; p < 0.01). A total of 52 women were not sexually active after therapy, and pain was the principal reason for the avoidance of sexual activity. Conclusions: The rate and severity of urinary, gastrointestinal, and sexual dysfunction were similar in the four groups of treatment. Nevertheless, ERT/CT was associated with worse sexual and urinary outcomes. [ABSTRACT FROM AUTHOR]