The possible role of vitamin A in the pathogenesis of bilharzial bladder cancer among Egyptians, particularly as it relates to the histopathologic tumor type, was investigated. Bilharzial patients and bladder cancer patients with squamous cell carcinoma, the most prevalent type in Egypt, showed significantly lower levels of vitamin A than normal male subjects. In contrast bladder cancer patients with transitional cell carcinoma had levels that were not significantly different from normal male subjects. The possible role of vitamin A in the etiology of bilharzial bladder cancer is discussed.