Blue light cystoscopy (BLC) improves the detection of bladder cancer at time of transurethral resection of bladder tumor for nonmuscle-invasive bladder cancer, this has translated to decreased tumor recurrence and time to recurrence. Given this improvement in rigid cystoscopy, the authors review the current evidence of BLC in the surveillance setting. The authors, Timothy N Clinton and Yair Lotan, Department of Urology, UT Southwestern Medical Center in Dallas, Texas, conclude that BLC is a safe and effective procedure in the outpatient surveillance setting to allow for increased detection rate of malignant bladder tumors. Early consideration from a prospective randomized trial is that intermediate and high risk patients could benefit especially early in their surveillance course when risk of recurrence is highest. Likely low-grade patients with large tumors or at their initial 3-month surveillance may also benefit. Furthermore, patients with abnormal lesions that are not classic for bladder cancer may benefit from returning to clinic for flexible BLC to determine, if lesions merit an operation. Evidence from a prospective registry will provide additional data on future outcomes and cost–effectiveness.