A simple method for combined light microscopy (LM) and scanning electron microscopy (SEM) of urinary sediment is described. Spontaneously voided cells were routinely collected onto a filter for cytologic study. Individual cells were photographed and demarcated by an ink grid pattern and puncture marks in the filter. The filter was prepared for SEM. The cells that were studied by LM could be readily located and examined by SEM. This study showed the importance of identifying individual cells before observation by SEM since cells with similar appearances by LM may have markedly different features by SEM, and vice versa. The results obtained in a series of patients with transitional-cell bladder carcinoma indicate that degenerative changes in voided urothelial cells negate the utility of SEM as a routine screening tool.