Background: In Egypt, carcinoma of the bladder is the foremost oncologic problem. It constitutes 30.3% of all cancers at the National Cancer Institute. UroVysion FISH is the first molecular test that uses DNA (Deoxyribonucleic acid) probes to identify the most common urothelial carcinoma related chromosomal abnormalities in urine.Aim of the work: To evaluate the ability of fluorescence in situ hybridization (FISH) technique in detecting bladder urothelial carcinoma and predicting tumor recurrence in patients with history of superficial urothelial carcinoma on follow up, as a non invasive technique and compare the results with standard cytology stained with hematoxylin and eosin.Patients and Methods: A prospective study conducted on 46 patients divided into 3 groups, Group A: 30 patients with history of superficial urothelial carcinoma of the bladder, GroupB: 8 patients with primary urothelial carcinoma, and Group C: 8 patients with cystitis. All patients were subjected to voided urine cytology and Urovysion before cystoscopy ± biopsy. Follow up for group A and one patient in group C with +ve FISH was done for 18 months. Results: The mean age of patients was 50.5 years. In group A we have found that 15 patients (50%) were FISH +ve and 15 patients (50%) were FISH – ve, and all patients were negative for malignancy by cytology and the first cytoscopy was free. Recurrence were diagnosed in 11 patients (36.6%) with median time to recurrence was 4 months. Anticipatory +ve FISH preceded recurrence in 81.8%, and the NPV was 86.6%. There was a statistically significant (P<0.01) difference in FISH results between low and high grade tumors. For group B, the sensitivity of FISH was equal to cytology (75%). For group C only one patient was +ve FISH and developed low grade Ta TCC after 12 months. Bilharziasis had no influence on the FISH results in urothelial carcinoma of the bladder. Conclusion: Our data suggest that Urovysion is a valuable tumor marker and can help in the detection of urothelial carcinoma of the bladder and until now it is the only tumor marker that can predicts tumor recurrence.