This review presents a comparative analysis of international guidelines for upper tract urothelial carcinoma (UTUC). The study systematically compared guidelines from the American Urological Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) to identify similarities and differences in their recommendations for diagnosis, treatment, and follow-up. The results showed that these three guidelines differ in their approach to diagnostic work-up, patient management, and follow-up. The EAU guidelines provide the most detailed recommendations, while the AUA and NCCN guidelines are more general. The study highlights the need for higher-quality research to create more consistent guidelines for the management of UTUC. The guidelines emphasize the importance of risk stratification, staging, and follow-up strategies. The study also discusses the role of environmental factors, such as smoking and aristolochic acid, in the development of UTUC. The guidelines recommend various imaging modalities, including contrast-enhanced CT scans and MRI, for diagnosis and staging. The study also addresses the management of UTUC, including endoscopic and surgical approaches, neoadjuvant and adjuvant chemotherapy, and immunotherapy. The guidelines emphasize the importance of follow-up strategies, including cystoscopy, imaging, and urine cytology, to detect recurrence and monitor disease progression. The study concludes that further research is needed to improve the consistency and quality of guidelines for the management of UTUC.This review presents a comparative analysis of international guidelines for upper tract urothelial carcinoma (UTUC). The study systematically compared guidelines from the American Urological Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) to identify similarities and differences in their recommendations for diagnosis, treatment, and follow-up. The results showed that these three guidelines differ in their approach to diagnostic work-up, patient management, and follow-up. The EAU guidelines provide the most detailed recommendations, while the AUA and NCCN guidelines are more general. The study highlights the need for higher-quality research to create more consistent guidelines for the management of UTUC. The guidelines emphasize the importance of risk stratification, staging, and follow-up strategies. The study also discusses the role of environmental factors, such as smoking and aristolochic acid, in the development of UTUC. The guidelines recommend various imaging modalities, including contrast-enhanced CT scans and MRI, for diagnosis and staging. The study also addresses the management of UTUC, including endoscopic and surgical approaches, neoadjuvant and adjuvant chemotherapy, and immunotherapy. The guidelines emphasize the importance of follow-up strategies, including cystoscopy, imaging, and urine cytology, to detect recurrence and monitor disease progression. The study concludes that further research is needed to improve the consistency and quality of guidelines for the management of UTUC.