Bladder cancer (BCa) is the ninth most common cancer worldwide. More than half of all BCa cases occur among the 20% of the world population living in countries with a very high Human Development Index (HDI) value. Moreover, the incidence of BCa is three times higher in men than in women. Approximately 80% of patients with BCa present with painless gross hematuria, which can be either continuous or intermittent. Most patients with suspected BCa should be submitted to an imaging workup to exclude other common causes of their signs and symptoms. Other noninvasive methods are urinary cytology and urinary molecular markers. At the moment, none of the molecular tests have been introduced into the diagnostic routine or at follow-up. Cystoscopy is considered the gold standard technique for detection, and, currently it is not replaceable by any other non-invasive test. Transurethral resection of bladder tumor (TURBT) under general anesthesia is the initial treatment to diagnose, stage, and resect all visible neoplasms. New technologies have been developed to enhance detection of bladder lesions, such as photodynamic diagnosis (PDD) and narrowband imaging (NBI).