Upper tract urothelial carcinoma (UTUC), which includes renal pelvis cancer and ureteral cancer, is classified alongside bladder cancer as a type of urothelial carcinoma. However, the overall incidence of UTUC is relatively low, and there are still some contentious issues in its diagnosis and treatment strategies. At the recent 2024 Annual Meeting of the Urological Surgeons Branch of the Chinese Medical Association held in Xi'an, Dr. Hailiang Zhang from Fudan University Shanghai Cancer Center delivered an insightful lecture titled "Systemic Treatment of UTUC: Challenges, Breakthroughs, and Future Directions." Following the conference, Urology Frontier invited Professor Zhang to discuss the characteristics of UTUC patients in China, perioperative treatment strategies, and the progress of his research team.