Caspases are crucial regulators of programmed cell death, mediating pathways such as apoptosis, pyroptosis, necroptosis and ferroptosis. Their activity is intricately controlled by epigenetic modifications, molecular interactions and post-translational changes, reflecting their central role in cellular homeostasis and disease mechanisms. Dysregulated caspase functions are linked to a wide array of conditions, including cancer, neurodegenerative disorders and inflammatory diseases, establishing their importance as potential therapeutic targets. The roles and regulation of caspases across subcellular compartments and their molecular interactions provide critical insights into the complexity of programmed cell death. Here, this review synthesizes current knowledge on the diverse functions of caspases, offering a comprehensive foundation for exploring innovative therapeutic strategies.