Sam S. Chang, MD, MBA, the Patricia and Rodes Hart Endowed Professor of Urologic Surgery and Oncology and the Oncology Fellowship Director and Vice Chair of Urologic Surgery at Vanderbilt University Medical Center in Nashville, Tennessee discusses guidelines related to nonmuscle invasive bladder cancer (NMIBC). Dr. Chang highlights the ongoing Bacillus Calmette-Guérin (BCG) shortage and its effect on treatment choices. However, FDA-approved systemic therapy is currently available for BCG-unresponsive disease, improvements in treatment and risk-stratification continue, risk-stratification continues to determine therapy and surveillance strategies, intravesical and/or systemic therapies are being studied and need enrollment support, and future improvements in tumor resection and predictive and prognostic biomarkers continue to develop.