&NA;The nomenclature of urothelial lesions has been a source of controversy resulting in a lack of standardization in terminology and confusing clinicopathologic conceptualization of important entities such as urothelial dysplasia. As a result of this problem, communication with clinicians regarding pathologic data has been at times unclear. A recent consensus conference has addressed these concerns and made meaningful recommendations. This review discusses practical issues in urinary tract pathology with an emphasis on defining diagnostic criteria for reactive, metaplastic, dysplastic, and neoplastic urothelial conditions.