This chapter describes the imaging techniques and surgical procedures involved in the staging and treatment of lymph node involvement in penile cancer patients. The indications and diagnostic qualities of imaging for the detection of inguinal, pelvic and distant metastases are discussed, followed by the use of (minimally) invasive techniques for detecting lymph node involvement with a specific focus on the dynamic sentinel node procedure. For penile cancer patients with tumour-positive nodes without distant metastases, the different approaches and complications of inguinal lymph node dissection and pelvic lymph node dissection are described. The role of (neo-)adjuvant therapies is presented in the next chapter of this book.