Primary osteosarcomas of the bladder account for about 0.04% ofbladder neoplasms. Most of the patients in the literature expiredwithin 6 months and, in almost all of the cases in the literature,radical cystectomy with postoperative chemotherapy was thetreatment choice. A 79-year-old gentleman presented with grosshematuria. Cystoscopy demonstrated a 2- to 3-cm tumour along thelateral wall of the bladder. The tumour was resected incompletelyvia initial transurethral resection of bladder tumour (TURBT), anda second TURBT was subsequently performed to fully resect theresidual mass. Surgical pathology from these 2 resections revealedosteosarcoma with invasion into the muscularis propria. Acystoprostatectomy was performed and final pathologic specimenrevealed high-grade CIS without evidence of residual osteosarcoma.Postoperatively, the patient did not receive chemotherapy orradiation and currently remains disease-free 2 years post-radicalcystectomy. Only 33 well-documented cases of primary osteosarcomaof the bladder have been reported to date. However, thereare only 3 cases in which TURBT resulted in complete resection.