Upper urinary tract urothelial carcinoma (UTUC) is a rare but aggressive malignancy requiring meticulous surgical management to prevent recurrence and ensure optimal oncological outcomes. Nephroureterectomy with bladder cuff excision remains the gold-standard treatment. Traditionally, the distal ureter and bladder cuff are managed via open or laparoscopic techniques; however, transurethral ureterovesical cuff resection (TUUVCR) has emerged as a minimally invasive alternative with promising results\. This review aims to evaluate the efficacy, safety, and oncological outcomes of transurethral ureterovesical cuff resection as part of nephroureterectomy for UTUC. A comprehensive literature review was conducted, analyzing studies focused on surgical techniques, oncological outcomes, recurrence rates, and complications associated with TUUVCR compared to open and laparoscopic approaches. TUUVCR demonstrates comparable oncological outcomes to open and laparoscopic methods while offering advantages such as reduced operative time, shorter hospital stays, and faster recovery. However, concerns remain regarding the adequacy of margin control and potential for tumor spillage. Technical challenges, such as proper visualization and resection depth, are critical factors influencing outcomes. Transurethral ureterovesical cuff resection represents a viable option in selected patients undergoing nephroureterectomy for UTUC. While initial evidence supports its efficacy and safety, further prospective, multicenter studies are needed to standardize the technique and confirm long-term oncological outcomes.