Clinical, anatomic and digestion studies were done in 91 surgically treated cases of bladder ulceration in Egyptian patients with urinary schistosomiasis. Most patients were rural male farmers; their mean age was 29 years. Symptoms were similar to uncomplicated urinary schistosomiasis except for suprapubic or perineal pain. Two clinicopathologic entities were noted: 1) sloughing of polypoid patches in early active disease; and 2) chronic schistosomal ulceration of the bladder occurring at sites of very heavy Schistosoma haematobium egg burdens. The gross appearance, location, size and shape are described. The cost of treatment and duration of hospitalization are noted.