A total of 11 patients were identified with an average age of 53 years (range 33 to 67), most of whom were male (M:F 9:2). Their median CD4 cell count was 280 cells/mm3 (range 106 – 572 cells/mm3) and median HIV load <50 copies/mL (range <50 – 665,000 copies/mL). Five (45%) patients smoked tobacco, two had recurrent cystitis, two had bladder calculi, and one patient had previous pelvic radiation therapy for cervical cancer. Nine (82%) presented with hematuria. Less common presentations included lower abdominal pain, irritative urinary symptoms (frequency, urgency and/or dysuria), and weight loss. Most cases (10/11) had transitional cell carcinoma and one person had squamous cell carcinoma. At presentation, two cases had stage 0a disease, five had stage I disease, and two stage IV disease. Treatment with transurethral resection of bladder tumor (TURBT) was followed by intravesical or systemic chemotherapy, cystectomy and/or radiation. Intravesical mitomycin C or epirubicin was used, despite the fact that BCG in one case did not cause complications. Several patients (64%) were alive following therapy, although many (71%) suffered from local relapse and metastatic disease.