The study systematically compared international guidelines on upper tract urothelial carcinoma (UTUC) to identify similarities and differences. The American Urological Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) guidelines were the only sources that provided detailed data on diagnosis, treatment, and follow-up of UTUC. The AUA and EAU guidelines showed more detailed indications, while the NCCN guidelines focused primarily on treatment options. The EAU guidelines also included a complete TNM staging system for UTUC. There was significant variability in the reporting of recommendations and opinions across the guidelines, particularly in risk stratification and follow-up strategies. The AUA guidelines recommended detailed follow-up plans based on pathological histology, while the EAU guidelines emphasized stringent follow-up, especially for high-grade tumors. The NCCN guidelines lacked sections on epidemiology and risk factors but provided brief presentations of diagnosis and follow-up. The study highlights the need for further high-quality research to create higher-grade consensus among guidelines and improve patient management of UTUC.The study systematically compared international guidelines on upper tract urothelial carcinoma (UTUC) to identify similarities and differences. The American Urological Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) guidelines were the only sources that provided detailed data on diagnosis, treatment, and follow-up of UTUC. The AUA and EAU guidelines showed more detailed indications, while the NCCN guidelines focused primarily on treatment options. The EAU guidelines also included a complete TNM staging system for UTUC. There was significant variability in the reporting of recommendations and opinions across the guidelines, particularly in risk stratification and follow-up strategies. The AUA guidelines recommended detailed follow-up plans based on pathological histology, while the EAU guidelines emphasized stringent follow-up, especially for high-grade tumors. The NCCN guidelines lacked sections on epidemiology and risk factors but provided brief presentations of diagnosis and follow-up. The study highlights the need for further high-quality research to create higher-grade consensus among guidelines and improve patient management of UTUC.