PURPOSE OF REVIEW: To present the recent advances in imaging for diagnosis, staging, and follow-up of bladder cancer. RECENT FINDINGS: The use of multidetector 64-slice computed tomography (CT) and diffusion-weighted imaging has enabled higher-resolution imaging of bladder cancer on CT and MRI, respectively, increasing both specificity and sensitivity in the detection of bladder tumors and extravesical disease relative standard imaging. Although urinary excretion of F-FDG produces difficulties in the interpretation of F-FDG PET/CT, new techniques have been described to overcome this limitation. The use of the agent C-acetate with PET/CT may be another option when performing imaging for staging and treatment decision-making. SUMMARY: Accurate and reproducible imaging is critical in the management of bladder cancer. The resolution of a number of imaging modalities has increased, likely allowing for improved treatment decisions. Further research is needed to improve the diagnosis of small and/or flat lesions.