88 The European Association of Urology (EAU) has released its updated 2024 guidelines on the management of non-muscle-invasive bladder cancer (NMIBC), focusing on advancements in diagnosis, treatment, and patient care. The new guidelines aim to address critical challenges in managing Ta, T1, and carcinoma in situ (CIS) bladder cancers, emphasising personalised care strategies for better outcomes. The findings were published in the journal European Urology. Bladder cancer, the tenth most common cancer globally, predominantly affects men, with smoking and occupational exposure to carcinogens identified as leading risk factors. Approximately 75% of bladder cancer cases present as NMIBC, which involves tumours that are limited to the bladder lining without muscle invasion. Despite being less aggressive than muscle-invasive bladder cancer, NMIBC requires precise management to prevent recurrence and progression. The updated guidelines highlight the importance of thorough diagnostic procedures, including cystoscopy and histological analysis, to ensure accurate staging and grading of tumours. Early identification of carcinoma in situ and other high-risk lesions remains a priority. Innovations such as enhanced imaging techniques, including fluorescence cystoscopy, have shown promise in improving diagnostic accuracy and reducing the likelihood of missed lesions. Risk stratification is central to the 2024 guidelines, with patients categorised into low, intermediate, high, and very high-risk groups based on tumour characteristics, patient history, and other clinical factors. This stratification allows clinicians to tailor treatments effectively, ensuring that high-risk patients receive aggressive interventions while minimising overtreatment in low-risk cases. For treatment, the guidelines reaffirm the value of transurethral resection of the bladder (TURB) as the cornerstone of NMIBC management. However, they also recommend second-look TURB for patients with incomplete initial resections or those at risk of residual disease. Adjuvant therapies, including intravesical chemotherapy and Bacillus Calmette-Guérin (BCG) immunotherapy, remain critical components for reducing recurrence and progression. The guidelines also reflect ongoing challenges in managing BCG shortages, encouraging alternative strategies such as combination therapies and device-assisted approaches like hyperthermic chemotherapy. Despite these advances, the optimal duration and dosing schedules for many treatments remain under debate, necessitating a personalised approach. Follow-up care is another focal point, with the guidelines underscoring the importance of regular surveillance through cystoscopy and cytology. The inclusion of patient-reported outcomes and quality-of-life measures ensures that treatment decisions align with patients’ preferences and long-term well-being. By integrating the latest evidence and technologies, the EAU aims to improve survival rates and quality of life for NMIBC patients. These guidelines serve as a critical resource for clinicians navigating the complexities of bladder cancer care, advocating for a balanced approach that prioritises both efficacy and patient safety.