Aberrant expression of CK20 and Ki-67 has been documented in many kinds of primary tumors and has proved useful as an ancillary diagnostic aid for those tumors. The aim of this study was to analyze the expression patterns of CK20 and Ki-67 in human bladder carcinomas (BCa) and to evaluate their clinical significance in the progression of BCa. CK20 and Ki-67 expression in BCa and normal bladder tissues were detected by immunohistochemical staining. The Spearman correlation was calculated between the expression of CK20 and Ki-67 in BCa tissues. The correlation of CK20 and Ki-67 expression with the clinicopathological characteristics and the prognosis of BCa were subsequently assessed. CK20 expression was positively expressed in 103/154 (66.9%) of BCa and 2/30 (6.67%) of normal bladder tissues, respectively. The positive expression rate of Ki-67 in BCa tissues was also significantly higher than those in normal bladder tissues (81.8 vs. 10%, p < 0.01). The Spearman analysis indicated that the expression level of CK20 has a significant positive correlation with that of Ki-67 (rs = 0.86, p = 0.02). Pathologic findings demonstrated that the intensity of CK20 and Ki-67 staining in cancerous tissues was associated significantly with tumor grades (p = 0.03, p < 0.01), distant metastasis (both p < 0.01) and TNM grades (p = 0.01, p = 0.03) of BCa. The progression-free survival of the patients with CK20 (+)/Ki-67 (+) expression was poorest (p < 0.01). The results suggest that the expression of CK20 and Ki-67 may be an important feature of BCa, and the detection of their co-expression may benefit the prediction of BCa prognosis.