ASCO produces guidelines for oncologists, utilizing a systematic review process. Although this resource-intense process results in authoritative and widely cited guidelines, they can cover only a few specific clinical issues. Hence, the ASCO guidelines presently do not fully address many clinical situations. Expanding the scope of ASCO guidelines will require major revisions to the guidelines development process. Changes likely to improve the process include establishing disease-specific committees composed of content experts, improving methods to resolve conflicts of interest, simplifying steps to engage members to suggest topics for new guidelines, and linking guidelines utilization with quality indices. In a time of rapid change in practice and research in cancer, ASCO can play a pivotal role in patient care through major revisions to guideline development, accessibility, and integration with quality metrics.