The clinical significance of thymosin β4 (Tβ4) expression in bladder transitional cell carcinoma (BTCC) remains unclear. The present study assessed the relationship between the expression of Tβ4 protein and the clinicopathological features, as well as the prognosis of bladder cancer patients. Tβ4 protein expression in 24 normal bladder and 138 primary BTCC tissue specimens was detected by immunohistochemistry, and the association of this expression with BTCC clinicopathological features and recurrence as well as patient survival was analyzed. Tβ4 expression was significantly stronger in BTCC patients than in normal volunteers. The expression of Tβ4 was significantly associated with differentiation capability, tumor stage and lymph node metastasis (P = 0.025, 0.043, and 0.039, respectively). Moreover, Tβ4 expression was positively correlated with integrin-linked kinase (ILK) and β-catenin expression (P = 0.042, 0.031, respectively) and inversely correlated with Ecadherin expression (P = 0.022). In the present cohort of bladder cancer patients, Tβ4 expression was found to be a predictor of poor survival (P < 0.05); however, high Tβ4 expression exhibited unfavorable prognostic value for recurrence. These data suggested that Tβ4 is correlated with the pathogenesis of BTCC. In addition, the patients with higher Tβ4 expression had a shorter survival.