Cancer represents a growing public health burden in Libya, yet epidemiological data remain limited. The absence of comprehensive cancer registries has resulted in a fragmented understanding of disease patterns and treatment practices. This study aimed to describe the demographic characteristics, clinical presentations, and patterns of chemotherapy utilization among cancer patients attending Sebha Oncology Centre, the sole specialized oncology facility serving southern Libya. A retrospective descriptive study was conducted at Sebha Oncology Centre. Medical records of patients diagnosed and managed between January 2020 and December 2021 were reviewed. Of 309 screened records, 110 met the inclusion criteria and were analyzed. Data extracted included sociodemographic characteristics, cancer type, stage at diagnosis, metastatic status, and treatment modalities. Associations between residence and clinical variables were assessed using Fisher’s Exact Test with effect sizes measured by Cramér’s V. The average age of patients was 51.39 years, with 62.7% aged between 41 and 64 years. Females constituted the majority of the cohort. Breast cancer was the most prevalent malignancy (42.7%), followed by prostate (12.7%) and colorectal cancers (8.2%). Most patients were diagnosed at Stage II (70.9%), and 36.4% presented with metastatic disease. A significant association was found between stage at diagnosis and place of residence, showing that patients from outside Sebha are more likely to present at Stage II. Chemotherapy was the primary treatment modality (80.0%), while surgical and radiotherapy options remained limited. Cancer patients at Sebha Oncology Centre are predominantly middle-aged females, reflecting the high burden of breast cancer. A significant disparity exists in the stage at diagnosis based on geographic residence. The heavy reliance on chemotherapy underscores infrastructure limitations in surgery and radiotherapy. These findings highlight the urgent need for early detection programs, improved oncology infrastructure in Libya, and enhanced healthcare access for rural populations.