In Germany misteltoe extract is one of the most commonly used complementary therapeutic strategies in oncology. There are anthroposophical as well as phytotherapeutic concepts to explain the potential mechanism of action; however, the oncological and uro-oncological literature lacks definitive proof to support recommendations on which is the most effective drug, the optimal dose, a clear indication or its efficacy. Weighting the current data, potential side effects and contraindications, the application of mistletoe extract in daily uro-oncological practice requires careful consideration of the indications in the context of a detailed patient informed consent and request for this unique therapeutic modality.