Diagnostic cystoscopy is the gold standard procedure in assessing anatomical variations and/or bladder pathologies. For example, for a clinician to adequately rule out carcinoma in situ of the bladder the clinician must directly visualize the whole bladder. Mastering this skill is thus incredibly important for the training MD and training advanced practice provider (Nurse Practitioner or Physician Assistant). Once mastered, this readily available reference will serve to benefit said clinician in differentiating benign and malignant pathologies. This text is designed as a comprehensive review by experts in the field of urology on the cystoscope, including both the flexible and rigid instrument, technical use, and certainly bladder pathologies. The rigid cystoscope includes three parts: the scope/lens, bridge, and sheath. These three parts may seem self-explanatory, however there are array of varying options within these three parts that have specific indications for use.