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The control of schistosomiasis in Egypt resulted in a striking change of the histologic profile of bladder cancer with decline of squamous cell carcinoma and rise of urothelial (transitional) carcinoma.Is to define the demographic and pathologic characteristics of the nonbilharzial urothelial carcinoma in a large series of Egyptian patients (530 transurethral resection samples), as well as to evaluate the risk factors (demographic, pathologic, and tissue biomarkers) in relation to stage progression (pT2).Displayed some differences from comparable western reports. The mean age was 62 years, males predominated (male female ratio 6 : 6), the nonpapillary pattern was common (51%), high-grade carcinomas contributed 40%, and invasion of muscularis propria (pT2) was common (56.2%). Only tumor pattern and grade had a significant relation with stage progression (pT2). In 62 cases, the four tumor tissue markers studied (p53, KI-67, E-cadherin, and metalloproteinase-2) did not show a significant relation with stage progression.Pathologic parameters are more important than biomarkers in determining stage progression. More research efforts are needed in early detection, validation of biomarkers by prospective clinical trials, and development of new models using multiple risk factors to increase their predictive power.