Dobšiná Ice Cave has attracted the attention of many researchers since its discovery more than 150 years ago. Although the cave is located outside the high-mountain area, it hosts one of the largest blocks of underground perennial ice. The topographic mapping of this unique UNESCO Natural Heritage site has led to several historical surveys. In the last decades of rapid climate change, this natural formation has been subject to rapid changes that are dynamically affecting the shape of the ice body. Not only increased precipitation, the rise in year-round surface temperatures, but also the gravity cause significant shape changes in the ice filling. This paper describes modern technological tools to comprehensively survey and evaluate interannual changes in both the floor and wall of the underground ice block. Technologies such as digital photogrammetry, in conjunction with precise digital tacheometry, make it possible to detect ice accumulation and loss, including the effect of sublimation due to airflow, as well as sliding movements of the ice block to the lower part of the cave. In the last two years, geophysical methods (microgravimetry and ground penetrating radar) have been added to determine the thickness of the floor ice in the upper parts of the cave due to the complexity of the measurements. The paper not only highlights the current technological possibilities but also points out the limitations of these technologies and then sets out solutions with a proposal of technological procedures for obtaining accurate geodetic and geophysical data.