A 31-year-old Japanese man who had been in Africa for two years presented with gross hematuria. He had been swimming in Lake Malawi during this period. Urinary specimen consisted of hematuria and pyuria. Cystoscopy showed tumors resembling Bilharzial tubercles located in the trigone, left lateral and posterior wall and dome. Further urine examination demonstrated eggs of schistosome haematobium. The patient was highly suspected of having Bilharzial schistosomiasis in the urinary bladder. Transurethral resection of bladder tumors was performed for diagnosis. Pathological examination revealed granuloma with many eggs of schistosome haematobium. He was diagnosed with Bilharzial schistosomiasis and was treated with 3,600 mg of praziquantel daily for two days. There have been no signs of recurrence during the one-year follow up except for excretion of degenerated eggs of schistosome haematobium in the urine specimens.