BACKGROUND Urothelial carcinoma poses a great challenge in disease management due to the high recurrence rate and a greater likelihood of disease progression. HER2 (human epidermal growth factor receptor 2) is one of the proteins variably expressed in urothelial carcinoma, prompting its investigation as a potential predictive marker. The aim of this study was to assess the HER2 status in urothelial carcinoma, its correlation with tumour grade, tumour stage, recurrence and progression. METHODS We retrospectively analysed 69 specimens of transurethral resection or cystectomy in patients with urothelial carcinoma. Immunohistochemistry for HER2 was performed and the expressions were correlated with tumour grade, tumour stage, presence of recurrence and tumour progression. Staining was evaluated according to the same criteria of breast cancer. Scores of 2+ and 3+ were considered positive. The data were analysed using the chi-square test with statistical significance set at P <0.05. RESULTS Positive HER2 expression was found in 13 cases (18.8%). HER2 positivity was significantly associated with high-grade tumours (P=0.005). However, there is no significant association with tumour stage, recurrence or progression. CONCLUSIONS HER2 is potentially a good immunohistochemical marker for identifying patients with higher-grade urothelial carcinoma and stratifying patients for future targeted therapy.