In a Review published in Nature Reviews Urology, Ploussard and colleagues discuss the evolving role of magnetic resonance imaging (MRI) in guiding active surveillance (AS) for patients with prostate cancer (Ploussard, G., Rouvière, O., Rouprêt, M., van den Bergh, R. & Renard-Penna, R. The current role of MRI for guiding active surveillance in prostate cancer. Nat. Rev. Urol. 19, 357–365 (2022))1 . We commend the authors for this informative Review, in which clear directions to overcome current limitations to the widespread acceptance of a fully MRI-guided AS pathway are outlined.