The chapter addresses the management of oncologic emergencies specific to urologic cancers. Genitourinary malignancies, such as renal cell carcinoma (RCC) and prostate cancer, are increasingly prevalent, necessitating prompt and specialized intervention in emergency situations. The chapter begins by discussing spontaneous perinephric hemorrhage, a rare but severe complication of RCC, highlighting the diagnostic challenges and the importance of hemodynamic stability in treatment decisions. It also covers hypercalcemia of malignancy, particularly its association with advanced RCC, detailing the pathophysiology, clinical presentation, and treatment options. Additionally, the chapter examines complications related to Bacille Calmette-Guérin (BCG) therapy, such as BCG-osis and BCG sepsis, emphasizing the need for early detection and appropriate antimicrobial therapy. Malignant spinal cord compression, a critical condition often seen in advanced prostate cancer, is discussed in terms of its diagnosis and multidisciplinary treatment approach. The chapter serves as a comprehensive guide for urologists in managing these life-threatening oncologic emergencies, ensuring timely and effective care for patients.