Taxanes have had a profound impact on the management of genitourinary tumors. In the perioperative and metastatic setting in bladder cancer, taxanes such as paclitaxel have an established role in combination chemotherapy strategies to improve survival. In metastatic prostate cancer, docetaxel was the only treatment, until recently, shown to improve survival after the development of castration resistance. More recently, cabazitaxel, a synthetic taxane derivative, is an effective option after docetaxel failure. In advanced testicular cancer, taxanes play an important role in the management of relapsed disease with the ability to still achieve cure. This chapter will focus on the development and current role of taxanes in the treatment of genitourinary cancers including bladder, prostate, and testis cancers as well as the status of novel agents currently under investigation.