It is well known that the immune microenvironment is critical to the progression of genitourinary malignancies and benign diseases. A variety of cellular and molecular properties of the immune microenvironment may influence disease outcome by altering the balance of suppressive versus inflammatory or cytotoxic responses. Emerging evidence suggests that immunoediting is a key factor of phenotypic change, immunological alterations caused by physical activity or drug treatments could promote antitumor or anti-inflammatory activity. Conversely, microenvironment deficits or dysregulation can instigate or worsen pathological progression, thereby contributing to urinary disease development and progression. Thus, understanding how immune microenvironments react and maintain appropriate antitumor or anti-inflammatory responses is important for identifying actionable therapies to improve genitourinary health. Recent technological developments, particularly in the areas of genetic modification and redox indicators, provide hopeful new treatments not only in urinary cancer, kidney cancer, bladder cancer, relatively rare adrenocortical cancer, and penile cancer but also in begin diseases like kidney stones and kidney injuries. The purpose of this topic is to provide up-to-date reviews and original articles that highlight research on immunological mediators of tumor progression and inflammatory-related genitourinary diseases, which we hope will not only integrate our current understanding but crystallize nascent questions that will help move the field forward. This research topic aims to inspire novel insights into the immunity mechanisms, novel therapeutic targets, and effective combinational strategies of urinary immunotherapies.