Purpose of review In vivo measurement of intrarenal pressure (IRP) during flexible ureteroscopy (fURS) have been reported. Yet, there is a paucity of literature on which is the ideal way and how each technique benefits or differs over the other. This review focuses on three established types of noninvasive IRP monitoring devices that can be inserted into the pelvicalyceal system retrogradely, namely pressure sensing guidewires, IRP monitoring flexible ureteroscopes, and IRP monitoring flexible and navigable suction ureteral access sheaths (FANS) integrated with a pressure-regulating system. We aim to provide evidence-based recommendations on how the information can be used in practice to enable the correct handling of IRP monitoring devices and accurate interpretation of data. Recent findings By summarizing the latest evidence on technological advancements, we will explore the principles of IRP monitoring, the correct use of available devices, and the interpretation of real-time IRP data. Furthermore, we will discuss the clinical implications of IRP management and offer recommendations for integrating these technologies into routine practice. Summary The review revealed