Abstract Background: Bladder cancer is one of the most common tumors of the lower urinary tract. It is the seventh most common malignancy that is found to be widely spread in developed countries. Aim of Study: Is to compare pre- and post-contrast multi-detector CT urography findings in detecting and characterizing urinary bladder neoplastic masses, using cystoscopy results as the gold standard for comparison. Patients and Methods: This comparative study was con-ducted on thirty patients, 25 men and 5 women. Over a six-month period, the patients were referred to the radiology department at Kasr Alainy University Hospitals. Patients with suspicious bladder mass(es) after clinical evaluation or for further characterization of an indeterminate bladder neoplastic mass lesion previously detected by other radiological inves-tigation such as ultrasound examination were included in the study. Results: There was a non-significant (p=0.537) difference in the lesion size pre-contrast (8.76±9.1) compared to post-contrast (8.79±9.0) MDCT studies. Both measurements had the same distribution regarding the site and morphology of the lesions. Both measurements had insignificant (p=0.101) difference in the distribution regarding extension of lesion. There was a significant (p=0.009) difference in the distribution regarding other findings of lesions (regional lymph nodes enlargement and back pressure changes). Conclusion: MDCT, pre- and post-contrast sequences, are completing each other in the detection and characterization of neoplastic bladder masses, with the conventional cystoscopy (CC) is still the gold standard for the evaluation of urinary bladder masses.