Enhanced Recovery After Surgery (ERAS) is a patient-centered, multidisciplinary, and evidence-based approach to surgical care. Initially developed for colorectal surgery, ERAS has been implemented in many surgical disciplines, including those involving pelvic surgeries. ERAS protocols aim to reduce the surgical stress response, shorten recovery time, and improve patient outcomes. This chapter discusses ERAS protocols in the context of radical cystectomy (RC) with pelvic lymph node dissection (PLND) and urinary diversion (UD), which is one of the most complex urologic operations and a good example for pelvic cancer surgeries. The application of ERAS protocols for RC, including preoperative, intraoperative, and postoperative considerations, is detailed using the University of Southern California’s experience as an example. The manuscript also highlights future directions for ERAS, including the potential role of prehabilitation and immunonutrition.