Volume 21, Number 4Review ArticlesIntravesical Therapy for Non-muscle Invasive Bladder Cancer—Current and Future Options in the Age of Bacillus Calmette-Guerin ShortageTreatment UpdateIzak FaienaKarim ChamieVishnukamal GollaAndrew T LenisNon-muscle invasive bladder cancer (NMIBC) is a common and burdensome malignancy. A substantial proportion of patients with intermediate- and high-risk disease will progress to invasive bladder cancer and are at a significant risk for metastasis and death. Bacillus Calmette-Guerin (BCG) therapy for selected cases has been the standard of care for nearly 40 years. Unfortunately, a world-wide shortage has made BCG challenging to obtain. Furthermore, recurrences and progressions do occur. With the US Food and Drug Administration creating a clear path to drug approval for novel treatments, many therapies have been tested, including intravesical cytotoxic chemotherapy, intravesical immunotherapy, systemic immunotherapy, and novel agents, such as gene therapy and targeted therapy. In this review, we highlight ongoing clinical trials. [Rev Urol. 2019;21(4):145–153] © 2020 MedReviews®, LLCImmunotherapyNon-muscle invasive bladder cancerBladder cancerIntravesical treatmentBCG shortage