Cancer of the urinary bladder is one of the most common urothelial neoplasms. Conventional cystoscopy is the mainstay in the diagnosis of urinary bladder malignancies. But, it is an invasive and uncomfortable procedure, associated with possible complications. Computed tomographic virtual cystoscopy has been proposed as an alternative technique for the evaluation of patients with urinary bladder tumors, with satisfactory patient acceptance and good results in detecting bladder malignancies. The introduction of multi-detector CT (MDCT) scanners allows the application of thinner collimation. The near isotropic pixels voxels achieved with a multidetector CT, enable the creation of multiplanar reformatted images and threedimensional renderings of outstanding quality. MDCT cystoscopy enables a fast and detailed evaluation of the area of the urinary bladder, with a short post-processing time. The combined evaluation of axial, multiplanar reformatted and virtual images should be used to improve the diagnostic performance of MDCT cystoscopy, especially when recognizing tumors of small size. The high efficacy of MDCT cystoscopy in the detection of urinary bladder tumors could probably obviate the need to perform conventional cystoscopy if virtual cystoscopy gives negative results and may validate the value of the technique for screening, primary diagnosis and surveillance of bladder carcinoma in the future.