The role of BCG on disease progression of NMIBC remains controversial with a 2002 literature-based meta-analysis showing a positive impact and a subsequent 2009 individual patient data (IPD) meta-analysis reporting a non-significant trend compared to Mitomycin C (MMC). The aim of this study was to compare the impact on progression of BCG versus TUR +/- chemotherapy in the new EAU high and very high prognostic factor risk groups.