Early diagnosis of bladder cancer is crucial to the prognosis of patients. How can bladder cancer be detected and diagnosed early? We should follow four recipes step by step, namely: abnormal urination should be alerted, initial screening of tumor by urinalysis, confirmation by cystoscopy, and comprehensive evaluation by imaging. The most common symptom of bladder cancer is hematuria without any feeling and visible to the naked eye, which is a unique “abnormal urination signal” of bladder cancer and occurs in almost every patient. About 85% of patients are seen for hematuria. Hematuria is more often seen throughout urination, or only at the beginning or end of urination. The hematuria is often painless and intermittent, and can reduce or stop on its own, which can easily create the illusion that the disease has healed. In addition, a small number of patients have symptoms of increased urination, urgency and painful urination like “cystitis”, so we should be alert to the possibility of bladder cancer in “cystitis” that is not cured by taking antibacterial agents for a long time. When people have the above “abnormal urination signals”, especially painless hematuria, even if it only occurs once, they should be fully alert and investigate to the end. 2.Tumor primary screening urine analysis: A few patients with bladder cancer can have no visual hematuria but only microscopic examination of urine with excessive red blood cells, i.e., microscopic hematuria, and other patients can have microscopic hematuria after the visual hematuria stops on its own. A very simple routine urine examination is valuable for early detection of bladder cancer when normal people pay attention to it during 1-2 annual general physical examinations. Most bladder cancers occur in the bladder mucosal epithelium, and tumor cells are easily mixed in the urine. Microscopic urine exfoliative cell examination is a simple, non-invasive and economical method for initial screening of patients with hematuria. Therefore, outpatient doctors should pay attention to routine urine microscopic examination and urine exfoliative cell microscopic examination. 3.Confirmation of diagnosis by cystoscopy: When a patient shows signs of abnormal urination, especially painless carnal hematuria, or repeatedly found microscopic hematuria, he should undergo cystoscopy. Cystoscopy is the only means to confirm the diagnosis of bladder cancer before surgery. The cystoscope is inserted into the bladder along the urethra to observe the whole bladder and the urethra at the same time to directly see the tumor site, size, number, degree of infiltration, etc. If biopsy is taken at the same time, the nature of the tumor can be clarified. Therefore, if it is clear that the patient is suffering from bladder cancer, it is necessary to perform intravenous urography to show the renal calyces, pelvis, ureter and ureter through intravenous injection of contrast agent to clarify or exclude whether there is suspicious tumor. In addition, ultrasound and CT examinations can help to estimate the extent and depth of bladder cancer infiltration and the presence or absence of surrounding lymph node invasion. Necessary imaging examinations are important for the overall assessment of the disease and decision of treatment plan.