We reviewed 25 patients who developed carcinoma of the bladder following spinal cord injury among a series of 6744 paraplegic and tetraplegic patients. An analysis of the incidence, presentation, possible predisposing factors and prognosis was carried out. The majority presented at a younger age and there was a significantly higher incidence of squamous carcinoma than in the non-paraplegic population. The anterior bladder wall was involved in about 25 per cent of the cases. The prognosis is poor.