Objective: To investigate the clinical significance of PCDH10 (protocadherin 10) promoter methylation in patients with bladder transitional cell carcinoma (TCC). Materials and Methods: 107 samples of bladder TCC and 38 normal bladder epithelial tissues were investigated using methylation-specific PCR, and the relationships between PCDH10 methylation and clinicopathologic features as well as patients' outcome were analyzed. Results: PCDH10 methylation was detected in 63 (58.9%) bladder TCC samples, but no methylation of PCDH10 was found in controls. Moreover, PCDH10 methylation was significantly associated with larger tumor size (p = 0.0074), non-papillary shape (p = 0.0268), tumor relapse (p = 0.0029), high grade (p = 0.0397), advanced stage (p = 0.0004) and poor prognosis (p = 0.0009). In addition, multivariate analysis indicated that PCDH10 methylation is independently associated with poor outcome and may be used as a useful independent prognostic factor (p = 0.0255). Conclusions: PCDH10 methylation is closely associated with malignancy of bladder TCC and may be used as an independent predictor for patients with bladder TCC.