Pronounced changes in the expression of ABO and Lewis antigens have been observed in transitional cell carcinomas compared with normal urothelium. These changes are associated with changes in the activity of blood-group gene-encoded glycosyltransferases. This paper describes the correlation between blood-group antigen expression and the activity of glycosyltransferases in transitional cell carcinomas. Examined individuals were A1A2BO, Lewis, and secretor typed by the use of blood and saliva. The activity of alpha-2-, and alpha-4-L-fucosyltransferases as well as the alpha-3-N-acetyl-D-galactosaminyltransferase were determined as p-moles of labelled sugar incorporated by Lacto-N-biose I and 2'-fucosyllactose, respectively, per 100,000 carcinoma cells. In 3 non-secretors whose erythrocytes types as Le(a+b-), the alpha-2-L-fucosyltransferase activity was similar to that in 3 secretors, and the Leb antigen could be demonstrated to be present by monoclonal antibodies, both by immunohistological and immunochemical means. In 11 tumors from A individuals, the A1-transferase was severely reduced in 9 individuals who showed a loss of A antigen expression, and present in 2 individuals with A antigen expression in cytoplasmic vesicles. In conclusion, we demonstrate a good correlation between individual glycosyltransferase activity and expression of blood group Leb and loss of expression of blood group A in transitional cell carcinomas. Immunostaining of neutral glycolipids separated by TLC showed the Leb-active glycolipids to be simple hexa-saccharides in both secretors and non-secretors.