Following the development of suitable equipment for the endoscopic application of an Nd-YAG laser in this department, the laser has been used routinely in the management of bladder cancer since 1978. To evaluate side effects and efficiency, 252 consecutive laser treatments were evaluated with a minimum follow-up of 12 months. Side effects were few (0.3% perforation) and patients tolerated the treatment very well. The general recurrence rate of T1 tumours varied from 33% for primary carcinomas to 54% for recurrent tumours, but the incidence of local recurrence was only 7%. The long-term results of laser treatment showed a decrease in the local recurrence rate when compared with the results of conservative electocautery resection, but there was no significant influence on the total recurrence rate.