Bladder cancer has the highest lifetime treatment and surveillance costs per patients for all cancers. New diagnostic tools, and ancillary tests, such as urine markers, have been developed to enhance the sensitivity for detecting cancer cells exfoliated from the urinary tract, and to reduce the discomfort of repeated cystoscopies. Several markers have been studied, and others are under investigation; a few provide some advantage, only in selected cases, in terms of detection rate and cost-effectiveness for the patient as well as the health service. This paper provides a concise update of the most promising urinary markers (nuclear matrix protein 22, ImmunoCyt, and fluorescence in situ hybridization) acting as non-invasive tests which help to identify urothelial cancers. Cystoscopy remains the most consistent examination for diagnosis and follow-up of non-muscle-invasive bladder cancer. However, some markers can be useful in understanding atypical cytology due to urinary tract phlogosis, infection, or treatment with chemotherapy or intravesical bacillus Calmette-Guérin. Moreover, in centers with clinical experience, selected patients may benefit from the use of urinary markers to achieve prognostic information at the specific time of individual follow-up.