Objective: To investigate the clinical significance of E-cadherin (E-CD) expression in human bladder transitional cell carcinoma (TCC) tissue and soluble forms of E-cadherin (sE-CD) in the urine of patients with TCC. Materials and Methods: One hundred and two specimens of bladder TCC and 10 normal bladder tissues were stained immunohistochemically with anti-E-CD monoclonal antibody. The urinary sE-CD from 59 subjects with TCC or controls was measured with enzyme-linked immunosorbent assay (ELISA). All results were analyzed statistically between groups. Results: The expression of E-CD in bladder TCC correlated well with grade and stage but had no significant correlation with the size or number of the tumors. Normal expression rate of E-CD is significantly higher in primary than in recurrent tumors. The level of urinary sE-CD was higher in patients with TCC than in normal controls or patients with benign disorders of the urinary system. Urinary sE-CD levels were strongly correlated with tumor grade but showed no significant correlation with the stage, size and number of the tumors. The urinary sE-CD level is significantly higher in the recurrent group than in the primary group. Conclusions: Expression of E-CD in the tissue of TCC and the urinary level of sE-CD are very closely associated with the biological behaviors of bladder TCC.