We report the case of a 67-year-old patient on hemodialysis with asymptomatic gross hematuria and increased PSA levels who was diagnosed with invasive bladder cancer. The postoperative histological studies revealed a bilateral renal cell carcinoma, right ureter and renal pelvis carcinoma in situ and prostate cancer. We believe this to be the first case of such a combination of synchronous urinary tract tumors. When treating urological cancer patients on hemodialysis, one should be aware of a possible combination of multiple synchronous urinary tract tumors.