The relationship between the urokinase-type plasminogen activator (u-PA) content in extracts of cancer tissues and the histological grade or the extent of the primary tumor as prognostic factors in bladder cancer were examined in 55 cases of bladder cancer. The patients were divided into 2 groups, high u-PA (8 ng/ml of protein and more) and low u-PA (less than 8 ng/mg of protein) groups. The incidence of vascular invasion was 37% in the high u-PA group, and 7.1% in the low u-PA group (p < 0.05). The incidence of high u-PA group increased with the grade of cancer and the extent of the primary tumor. The 3-year survival rates were 87.3% in low u-PA group and 42.6% in high group (p < 0.005). The survival rates of the patients in the high u-PA group were lower than in the low group, by grade or stage. In a multivariate analysis, the prognostic value of u-PA antigen content was the same as that of tumor grade and stage. Therefore, the content of u-PA may be a useful prognostic marker for bladder cancer in addition to tumor grade and stage although the prognosis of the patients with bladder cancer is considered to be determined by many factors.