Over the last decade, there has been progressive advancement in the field of breast and axillary localisation, driven by advances in technology and innovation. The gold standard wire-guided localisation (WGL) has been replaced by wireless technology leading to enhanced patient pathway and improved surgical efficiency. This chapter addresses the emerging and future trends with emphasis on image-guided techniques including nano-technology and artificial intelligence. The advancements will lead the way to precision surgery, optimising surgical pathway and leading to high-quality patient-centred care.