Primary malignant urethral neoplasms are unusual in women. Those of mixed histologic type are so rare as to define adequate documentation. We report the case of an elderly black woman with an urethral carcinoma which had features of a transitional cell carcinoma as well as clear cell adenocarcinoma. The histologic and ultrastructural features are presented and the histogenesis is discussed. Although the patient had both high grade and high stage disease and failed initially after external beam radiation therapy, she is alive and well, without evidence of recurrent disease, 19 months after anterior exenteration.