PIG3 (p53-induced gene 3) is one of the targets of TP53 and is involved in apoptosis. The promoter of PIG3 contains a variable number of tandem repeats (VNTRs) of pentanucleotides (TGYCC)n (Y = C or T) and the number of VNTRs was reported to be correlated with the activation by TP53. In this study, the clinical significance of the PIG3 promoter VNTRs was analyzed in the bladder cancer patients using the genome DNAs from 338 controls and 273 bladder cancer patients. There was no significant difference in the allele frequency of the PIG3 promoter VNTRs between them. However, the presence of 14 or less repeats allele was associated with higher cancer grade (P = 0.038) and higher stage in relative risk (adjusted odds ratio = 2.31, 95% confidence interval = 1.05-5.90). These data suggested that the PIG3 promoter VNTRs was associated with generation of invasive bladder cancer.