Purpose of Review <p>This narrative review provides an overview of the status, limitations, ongoing initiatives, and future direction of urology training in low- and middle-income countries (LMIC).</p> Recent Findings <p>A striking global workforce gap for urologists exists in LMICs, partly due to the wide variability, or in some cases, absence of formal urology training programs. Studies show major barriers include limited financial and human resources, inadequate infrastructure, time constraints due to clinical volumes, and lack of sustainable partnerships. Significant efforts, both locally and by global partnerships, however, have been made to advance local training efforts. Further, innovations in artificial reality, simulation-based education, telesurgery, and standardized online curricula, may offer a particular benefit to LMICs in helping to change the educational landscape for urology in these settings.</p> Summary <p>LMICs face a significant shortage of urologist and standard training programs. Long-term progress depends on investment in training, fostering trusted partnerships, and empowering LMIC leadership in education, research, and professional visibility. Through innovation, collaborative efforts and support for locally driven initiatives, the global community can strengthen the urology workforce to improved delivery of high-quality care.</p>