The American Cancer Society estimates that 57,400 new cases of bladder cancer will be diagnosed in the USA in 2003 and that approximately 70% of these cases will be superficial bladder tumors. Due to the high risk of recurrence, patients with superficial bladder cancer represent an ideal group for chemoprevention. Intravesical chemotherapy or immunotherapy is often administered in an attempt to prevent tumor recurrence in high-risk patients, although it is not without toxicity. A large body of evidence links diet and nutrition with bladder cancer. This review summarizes the efficacy of natural and synthetic agents that have purported chemopreventive activity.