Bladder cancer is the most common malignancy involving the urinary system, caused primarily by tobacco use and exposure to industrial chemicals with an estimated 73,510 patients affected and 14,880 deaths in 2012. This chapter will summarize what is known about the most common molecular derangements in human bladder cancer. It will focus on the function and biological/clinical relevance of these genes in models of urothelial cancer and in patients with this disease. It is not meant as a comprehensive review of all the functions of the aforementioned genes in normal physiology or other cancer types. Furthermore, the selection of what genes/pathways are described is by necessity empirical and so we apologize to any author whose work was not described or quoted.