Aim of Work: Assessment of angiogenesis and vascular invasion, as markers of tumor progression, in both bilharzia- and non-bilharzia-associated, human urothelial bladder cancer and their correlation with the pathological features of such tumors. Methods: Vessels were stained using an antibody to the platelet endothelial cell adhesion molecule, CD31, for detection of MVD and vascular invasion. Tumor cells were stained using VEGF monoclonal antibody. MVD, VEGF score and vascular invasion were evaluated in relation to tumor grade, stage, muscle invasion, presence of divergent histologic differentiation, bilharzia association and lymph node metastasis.Results: The MVD ranged from 0 to 201, and by using the ROC curve, the cut off point of MVD in relation to muscle invasion was 20. MVD-20 had high significant relation (p=0.000) with each of tumor stage, muscle invasion, grade and presence of divergent differentiation. 16% of cases showed vascular invasion assessed by CD31 staining of endothelial cells and the presence of vascular invasion was significantly correlated with tumor stage (p=0.02) and muscle invasion (p=0.04). 78% of cases showed high VEGF expression, and VEGF score was significantly related (p=0.005) to lymph node metastases. There was significant relation between vascular invasion and MVD 20 (p=0.04).Conclusions: Increased neovascularity is probably responsible for the aggressive appearance and behavior of the tumor and increased probability of vascular invasion. Tumors with high VEGF expression, most probably will be accompanied by lymph node metastases. Further studies are needed to clarify the angiogenic effect of bilharzial association in urothelial tumors.