A 66-year-old female complained of fever and lumbar pain was diagnosed as the squamous cell carcinoma associated with vesical leukoplakia cystoscopically. Histopathological figures showed various forms of squamous metaplasia, involving squamous cell carcinoma nests within it. Now, the relationship between vesical leukoplakia and squamous cell carcinoma is not obscure. Then the treatment of the leukoplakia has been considered conservatively (fulguration, acidification of the urine and anti-microbials). Now, we can classify the lesions of squamous metaplasias into two types in the urinary bladder. The possibility of the malignant change in the leukoplakia lesions could be suggestive of the histological characteristics; irregularly down growth and disarrangement of the basal cells and/or dispersed basement membrane in rete pegs in the metaplasia.