Twenty cases with 51 tumor foci of urinary bladder were treated by Nd:YAG laser local irradiation plus whole-bladder photodynamic therapy (PDT) with hematoporphyrin derivative (HPD). All cases were confirmed by histopathological diagnosis. Of the 20 patients, 19 were cured after one treatment (95%) and the other patient cured after 2 treatments within 40 days. On follow-up for 3-23 months, tumor recurrence occurred in 2 cases (10%) about 3-6 months after treatment. The results suggest that the PDT effect in destroying bladder tumors might be enhanced by Nd:YAG laser while the lesions escaped Nd:YAG laser irradiation could be handled by whole-bladder PDT.