Seven cases of adenocarcinoma of the urachus treated at the National Cancer Center Hospital, Tokyo, over a nineteen-year period are reported. One hundred fifty-five cases reported in English literature and 140 cases in Japanese literature were analyzed with respect to the modalities of treatment, mean remission times, and sites of recurrence or metastases. From this review and experience on the 7 cases reported here, extended radical total cystectomy with well-designed radio- and chemotherapy was proposed for the treatment of this disease.