Radical cystectomy with some form of urinary diversion still remains the most commonly used method to treat patients with carcinoma of the bilharzial bladder. The reported 5-year survival rate following this procedure ranges from 27 to 38 per cent. Research efforts currently are directed to 2 areas. One area is screening the population at high risk by urine cytology for detection of early cases. This procedure may either improve the end results of existing methods of treatment or allow the adoption of techniques of lesser magnitude than radical cystectomy with its attendant relatively high mortality and inevitable physiologic and functional losses. Studies also are in progress in an attempt to enhance the therapeutic yield of the current treatment modalities. Preoperative radiation and cystectomy are examples. The possibility of promotion of the radioresponsiveness and improvement of the therapeutic response also is being explored by administration of chemical hypoxic cell sensitizers and/or the application of more optimized fractionation techniques.