Bladder cancer is extremely rare in young patients. We reported the clinicopathological outcomes in adolescent and young adult patients with bladder cancer, using age 35 as the cut-off. From 1972 to 2011, 1349 patients were treated with transurethral resection of bladder tumor. Thirty patients were ＜35 years of age and were divided into two groups : ＜30 and ≧30 years. We reviewed the initial symptoms, cystoscopic and pathological findings, and prognosis. Thirteen patients (0.96%) were ＜30 years of age and seventeen (1.3%) were ≧30 of age, with mean follow-up periods of 88.2 and 77.6 months, respectively. The most common complaint was gross hematuria. Most tumors were solitary (26 ; 86.7%) and papillary (29 ; 96.7%). Pathological stages were pTa 15, pT1 10, and pT2 3. Patients with pT2 cancer were ≧30 years of age (p ＝ 0.019). One patient died of bladder cancer. The majority of patients had low-grade, low pathological stage bladder cancer and a good prognosis. However, some pT2 cancers exhibited aggressive behavior.