An 81-year-old woman was admitted with a chief complaint of bloody discharge from the urethra. On physical examination an elastic-soft mass was palpable beneath the anterior vaginal wall. Magnetic resonance imaging and computed tomographic scan revealed the mass around the urethra. Transvaginal needle biopsy was performed and the histopathologic finding was adenocarcinoma. The tumor was excised with the uterus, the ovary and the anterior vaginal wall. The macroscopic appearance suggested that the tumor arose in the urethral diverticulum. She had intravesical recurrence at 8 months after the operation, and partial cystectomy was performed. However there was recurrence again, and radical cystectomy was performed finally. We review 81 cases of urethral diverticular carcinoma in the literature.