With the increasing emphasis on precision medicine in oncology and the need for biomarker testing, pathologists and the pathology community are in the center of the patient's tissue journey. As guardians and stewards of the tissue, pathologists are responsible for ensuring the quality of samples used for accurate diagnosis and biomarker testing. Pre-analytics - the collection, handling and processing of clinical biospecimens - are critically important but rigor around the control of factors that adversely affect biospecimens is lacking. TTargeted for Pathologists and Pathology Assistants, this video is an introduction to the Tissue Optimization and Pre-analytic Standardization (TOPS) program developed by APPIA and is narrated by Dr. David G. Hicks, Professor of Pathology and Director of IHC-ISH Laboratory and Breast Subspecialty Service at the University of Rochester Medical Center. It provides a thorough review of how the lack of standardization of pre-analytic factors has the potential to negatively impact the quality of the tissue specimen for downstream diagnostic and molecular testing. Examples of best practices to help optimize tissue preservation and quality and how these can be implemented in clinical practice are discussed.