Primary urachal adenocarcinoma (PUA) is a rare form of cancer that arises from the urachus, a vestigial remnant of the allantois and cloaca during embryonic development. The exact pathogenesis of PUA is not well understood, but it is believed to arise from glandular epithelium remnants within the urachus. The rarity of this type of cancer makes it difficult to comprehensively study its epidemiology. METHODS This case report describes a 47-year-old male patient who presented with intermittent painless hematuria and fatigue for two months. Cystoscopy showed a single growth at the dome of the urinary bladder, and abdominopelvic CT scan with contrast revealed a 3*2 cm enhancing growth at the dome of the bladder suspicious of urachal origin tumor. The patient was diagnosed with urachal adenocarcinoma (PT2) after pathological examination. The patient underwent partial cystectomy and umbilicectomy. Patients with PUA often present with nonspecific symptoms that can delay the diagnosis. The most common symptom is hematuria, which is present in approximately two-thirds of the patients. The diagnosis of PUA is challenging and relies on a combination of clinical presentation, imaging, and histopathological examination. CONCLUSIONS The mainstay of treatment for PUA is surgical resection, which may include partial cystectomy or radical cystectomy with en bloc resection of the urachus and umbilicus. It is esential to report all cases of primary urachal adenocrcinoma.