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Bladder cancer is the sixth most common malignant tumor. The course of the disease depends largely on histological findings. A combination of transurethral resection and intravesical chemotherapy is indicated in superficial tumors and is able to cure most patients with a well differentiated cancer. Contrary to that, muscle-invasive and poorly differentiated tumors take a much less favorable course. They can be offered novel combined therapeutic approaches or/and at least orthotopic continent bladder substitution. It seems possible that the recently observed trend towards improved overall survival may continue. In the future, there should be more emphasis on prevention (elimination of carcinogens and early detection).