The fibrotic contracted bladder and ureteric strictures are the main complications of urinary bilharziasis. Papillomas and carcinomas of the bladder are very common but with the latter the causative feature of bilharziasis is not certain. Bilharziasis can be seen occasionally in Europe as travelling to endemic regions is in vogue. At the Ifakara Hospital in Tansania, 11 cases of complicated urinary bilharziasis with ureteric stricture and contracted bladder have been observed. Four patients have died, seven could undergo an operation. To six patients an ileocystoplasty was done in order to enlarge the bladder capacity and the distal ends of the ureters have been resected and anastomosed to the new bladder. In one case, a child, a latero-lateral ureterocystostomy on both sides was done only. All the patients who underwent operation could be discharged after they had improved considerably.