BACKGROUND Condyloma acuminatum is a rare finding of the urinary bladder. There are many morphological variants that exist. It has been previously reported that some of these variants were found to be associated with subsequent or concurrent squamous cell carcinoma. However, there are limited cases that describe this underlying malignancy found in patients with bladder condyloma. METHODS A 38-year-old African American female presented with condyloma acuminatum of the urinary bladder and underlying squamous cell carcinoma, which also invaded the neighboring uterus, urethra, and anterior vagina. Initial attempts at treatment began with cystoscopic resection of the condyloma; however, due to diffuse transformation, we pursued radical cystectomy with adjuvant chemotherapy and radiation. CONCLUSIONS As such a finding is rare in the urinary bladder, with few reports discussing its association with ensuing squamous cell carcinoma, we hope that this continues to generate awareness and consideration in the treatment of affected individuals.