Background: Bladder cancer accounts for about 7% of all cancers among adults in Iran. We aimed to evaluate epidemiological and clinicopathological features of bladder cancer in Kermanshah province, west Iran.
Methods: In a descriptive retrospective study, records of patients with bladder cancer referring to Imam Reza Hospital, Kermanshah city, Iran during 2011-2013 were analyzed. Sex, age, smoking habits, patients’ symptoms, histopathology and staging of the tumor were extracted from the records. The grading of the tumor was performed according to the Ash grading system. 
Results: 220 patients were registered. 179 (81.4%) were patients men. The mean±SD age for patients at diagnosis was 62.5±15.1 years (range: 14-90 years). 71 (43%) patients were smokers. 165 (75%) patients were from rural areas. Hematuria, dysuria, and frequent or painful urination were reported in 74.5%, 5.5%, and 41.8%, respectively. Transitional cell carcinoma was the most common pathology in 93.2% of the patients. Grade І, ІІ, ІІІ and ІV tumors were observed in 0.5%, 41.5%, 37% and 21% of the patients, respectively. 
Conclusion: Bladder cancer occurs most commonly in the elderly. Bladder cancer in Asia is more common in men compared with Europe and Africa. Since hematuria was the main presenting manifestation of the patients with bladder cancer, elderly patients with hematuria should be referred  at the earliest convenience for investigation.