Over the last 11 years we have treated 47 patients with infiltrating bladder carcinomas with the neodymium:YAG laser alone or in combination with TUR. After a mean observation period of 3 1/2 years (19-133 months) 39 patients (83%) were still alive. Only two of them showed tumor dissemination. Thirteen patients (27.7%) had no recurrent disease after laser therapy. Mostly heterotopic recurrences with no tumor progression were found in 23 patients (48.9%). Six patients (12.8%) developed recurrences with progression, including two cases with pelvic lymph node metastases. Five patients (10.6%) died of their tumor disease and three of myocardial infarction, having shown no signs of tumor recurrence at the last follow-up examination.