Objective: To evaluate the comparative efficacy of adjuvant gemcitabine and cisplatin (GC) chemotherapy between patients with locally advanced transitional cell carcinoma (TCC) of the bladder and upper urinary tract. Patients and Methods: From 2001 to 2005, we retrospectively selected a total of 64 patients with locally advanced TCC of the bladder and upper urinary tract who received at least 3 cycles of adjuvant GC chemotherapy. We compared disease-free and overall survival between the 2 groups. Results: The recurrence rate was 30.3% in TCC of the bladder and 25.8% of the upper urinary tract (p = 0.633). Statistical analysis revealed that there was no significant difference in the disease-free or overall survival rate between TCC of the bladder and upper urinary tract treated with adjuvant GC chemotherapy. Conclusion: Under the circumstances of limited data about TCC of the upper urinary tract, this study may suggest that adjuvant GC chemotherapy in locally advanced TCC of the upper urinary tract is as effective as those of bladder.