As the care of patients with cancer becomes increasingly complex and therapeutic options more nuanced, genomic data has become as essential as clinical information in guiding multidisciplinary decision-making across the continuum of care. To optimize outcomes for patients with urological malignancies, City-Wide Uro-Oncology Tumor Board are being conducted at Aga Khan University (AKU), Karachi, and at Sindh Institute of Urology and Transplantation (SIUT). These forums bring together multidisciplinary teams to integrate clinical, radiological, pathological, and genomic data, facilitating evidence-based, personalized treatment strategies and advancing the standard of uro-oncology care within the city.