ABSTRACT Background: In locally advanced and metastatic urinary bladder carcinoma, palliative radiation therapy aims to palliate symptoms with acceptable toxicity. Objective: Evaluation of the role of low dose short hypofractionated radiotherapy in improving symptoms of bladder cancer indefinitely, as long as it does not cause unacceptable toxicity. Patients and Methods: From July 2018 to July 2020, 24 patients with advanced bladder cancer were included in a trial at Zagazig University Hospitals' Clinical Oncology & Nuclear Medicine Department. All patients received a total dose of 21Gy of conformal radiation (7 Gy/fraction in 3 fractions, a fraction every other day over one week). Results: There was statistically significant improvement in haematuria symptoms among the studied patients. Also, there were no statistically significant changes in bowel frequency symptoms, diarrhea symptoms and bleeding symptoms. There were no significant changes in symptoms at 3-month assessment compared to end of treatment assessment while there was increase in percent of patients with symptomatic improvements especially in haematuria, dysuria and nocturia symptoms. Conclusion: Low dose hypofractionated radiation therapy protocol showed effective palliation of urinary symptoms with an acceptable toxicity.