Between March 1983 and March 1988 we registered and treated 49 patients with bladder cancer less than 40 years of age (7 patients less than 30 years of age). Hematuria was present in 40 cases (81.6%). 33 of the patients had a pTA tumor (67.3%). 47 patients had transitional carcinoma of the bladder, of which 21 (44.7%) showed hallmarks of aggressive behavior (muscle invasion, recurrences, associated severe epithelial atypia); all of these patients were between 31 and 39 years of age. 15 patients had a recurrence (30.6%), of which 3 showed progression (all between 31 and 39 years of age). This report supports the view that transitional cell carcinoma of the bladder is less aggressive in patients less than 30 years of age. We still advise however to do a full diagnostic workup in case of symptoms of bladder tumor, and to treat the patient according to the pathological classification, regardless of the age.