Background: Carcinoma of the urinary bladder is one of the most common cancers worldwide. It is the fourth most common malignancy in men and the ninth most common malignancy in women. In Egypt, carcinoma of bladder accounts for 20.6% of all tumors. 80% of patients who initially present with bladder TCC are superficial tumors. Superficial bladder tumors represent a heterogeneous group of cancers that include: papillary in nature and limited to the mucosa (Ta), invasive into the lamina propria (T1), and high grade, flat and confined to the epithelium (CIS). Superficial bladder cancer is characterized by its tendency to recur and to progress to deep invasion, so the aim of its treatment is to reduce tumor recurrence, the subsequent need for additional therapies, the morbidity associated with these treatments, and to prevent tumor progression and the subsequent need for more aggressive therapy.Aim of work: To study the clinico-pathologic characteristics of cases with superficial bladder cancer, and to correlate them with the patient outcome as regard recurrence and progression.Materials and methods: We collected 71 cases of superficial bladder cancer from pathology department at NCI from January 2000 to December 2007 with a minimum follow up period of 3.5 years.All available hematoxylin and eosin slides were reviewed for confirmation of diagnosis, with complete follow up of the patients to determine disease recurrence and progression.Results: Correlation between progression to deep invasion with the different clinico-pathologic parameters revealed statistically significant relationship with grade of tumor and bilharziasis, and borderline significant relationship with multifocality, time of first recurrence and recurrence at first follow up cystoscopy (after 3 months). Kaplan Mayer analysis to determine probability of progression to deep invasion revealed statistically significant increase in progression to deep invasion at one and three years in tumors with high grade and presence of bilharziasis, and borderline significant relationship with multifocality, time of first recurrence and recurrence at first follow up cystoscopy (after 3 months). Conclusion and recommendations: In superficial bladder tumors grade and bilharziasis appeared to be important prognostic factors for progression to deep invasion, followed by multifocality, time of first recurrence and recurrence at first follow up cystoscopy.We strongly recommend application of large scale studies including survival analysis, with emphasis on bilharziasis in order to settle an evidence based scoring system allowing better stratification of patients to meet with the most appropriate and effective therapeutic intervention.