Bladder perforation resulting from the use of the neodymium:YAG laser. Complications resulting from the use of the neodymium:YAG (Nd:YAG) laser to treat superficial bladder cancer are uncommon and are usually associated with abnormally high laser power outputs. We report a case of bladder perforation in a human attributed to the Nd:YAG laser used at a low power setting and comment on those factors that contributed to this complication. 