The current guidelines recommend the use of biomarkers in upper tract urothelial cancer (UTUC) primarily in terms of a diagnostic and prognostic approach. In the diagnostic and follow-up setting, the utilization of urinary cytology is recommended. In the prognostic setting, the guidelines suggest the application of laboratory parameters and molecular biomarkers However, biomarkers in the UTUC offer further advantages extending far beyond the diagnostic and prognostic setting. In particular current developments regarding genetic, epigenetic, and molecular assays allowing a molecular characterization of the disease have to be considered. By providing a real-time insight of the tumor genome during all stages of the disease, these approaches are of key interest in the development of individual therapy approaches of UTUC patients. Aim of this chapter is to provide a comprehensive overview about current guideline recommendations, about further available conventional biomarkers and about the potential of current developments in the area of genetic biomarkers.