The narrow band imaging (NBI) is a new technology introduced to complement the traditional endoscopy in order to enhance the detection of nonmuscle-invasive bladder cancer and, consequently, to improve the management of the disease. In this review, we considered the most important studies about the use of NBI in the diagnosis and treatment of bladder cancer. Current results demonstrate a greater sensitivity in the diagnosis of bladder cancer and especially a better negative predictive value of cystoscopy enhanced by NBI technology than white light standard cystoscopy. Similarly, improving the performance of endoscopic resection, this new technology would have a positive therapeutic impact in order to decrease residual tumors and relapses. The validation of the results and diffusion of NBI in clinical practice may provide new perspectives in the management of nonmuscle-invasive bladder cancer.