We report a 660 gram stone in the urinary bladder of an otherwise healthy 69 year old male. The stone gave rise to only minor subjective symptoms, but urograms revealed dilatation of both the ureters. The stone was removed by open cystolithotomy. Giant bladder stones are rare in modern urologic practice. In earlier centuries, however, bladder stone formation was a common urinary tract disease with need for surgery. A brief survey of historical lithotomy methods is given.