Recent advances behind the understanding of the molecular mechanisms of bladder tumorigenesis have contributed towards the identification of molecules that can act as potential therapeutic targets for novel agents. Concurrently, this has also led to the understanding that effective therapy for superficial and invasive bladder cancers will entail a combination of therapeutic agents that target multiple tumorigenic pathways. Management of bladder cancer patients, as is the case in many other solid tumors, may witness radical transformations in the coming years as we translate our molecular understanding of the disease into novel clinical trial designs and screening techniques.