The urinary bladder is the most common site of cancer in the urinary tract. Squamous cell carcinoma (SCC) accounts for only 1% of bladder cancer in England and around 5% in US. In an Egyptian series SCC represented 59% of 1026 cystectomy specimens. Most of SCCs in Egypt are associated with Schistosomiasis. The aim of imaging is to assess the extent of the local tumour and to detect tumour spread to lymph nodes and other organs. Anatomical and functional information to help in making therapeutic decisions can be obtained using different imaging methods. The first treatment decision is whether the patient has a superficial or muscle-invasive tumour. If it is superficial, patients should undergo MR imaging to confirm lack of invasion prior to undergoing trans-urethral resection (TUR). Further imaging modalities, such as CT, bone scan, PET and certain MRI techniques, are reserved for patients with muscle-invasive bladder cancer. The second treatment decision, based on staging, is to identify patients with organ-confined from patients with non-organ confined cancer and in particular those with locally advanced or metastatic disease. Computed tomography (CT) cannot differentiate accurately between organ-confined and extravesical extension. The correlation between CT findings and tumour extent in cystectomy specimens is 65-80%. MDCT urography is helpful for monitoring patients undergoing neo-adjuvant chemotherapy or bladdersparing treatment modalities. Magnetic resonance imaging (MRI) cannot detect microscopic extension into the perivesical fat. However, the overall accuracy of MR staging remains better than CT by 10-30%. Learning Objectives: