Jeffrey M. Holzbeierlein, MD, Director of the Division of Urologic Oncology at the University of Kansas Hospital and Director of Clinical Research for the Urology Department at KUMC, talks about how to manage high-grade T1 bladder cancer (HGT1BC). He discusses 5-year progression rates of HGT1BC, pathological substratification of the disease, and risk calculators to estimate patient progression. Dr. Holzbeierlein concludes by discussing enhanced cystoscopy, the value of re-resection, and the importance of bacillus Calmette-Guerin (BCG) maintenance in HGT1BC.