Actinomycosis of the urinary bladder is rare, mostly subsequent to abdomino-pelvic infection, and usually affects women with long-term use of an intrauterine device. We describe a case of vesical actinomycosis mimicking a papillary bladder tumour in a 56-year-old woman with primary manifestation of the disease in the genital tract, subjected to two transurethral resections after relapse of a polypoid mass in the bladder. Urological procedures are necessary to differentiate actinomycosis from bladder cancer and the diagnosis is often made histologically.