We investigated the safety, technique, and effectiveness of holmium laser resection of bladder tumors (HoLRBT). Data are presented on 23 patients who were treated with the HoLRBT technique. Holmium:YAG laser has a wavelength of 2,140 nm, which is delivered in a pulsed fashion via an end-firing quartz fiber placed through a modified resectoscope. Twenty-three patients with newly diagnosed transitional cell carcinoma underwent HoLRBT. Cold cup biopsies of the bladder tumor base were taken and compared to the HoLRBT specimens. Twenty-two of 23 patients were discharged catheter-free within 24 hours. One patient required a catheter for 3 days. The mean total energy used was 13.14 kJ with a maximum of 34.31 kJ. Mean resection time was 18.6 minutes. Cold cup biopsy of the tumor base did not alter the stage of the bladder tumor. The HoLRBT technique can be used to safely and effectively treat bladder tumors. This laser technique did not alter the stage or the diagnosis of bladder tumors. Holmium resection of bladder tumors usually can be performed as an outpatient catheter-free procedure and is a viable alternative to the standard electrocautery transurethral resection of bladder tumors.