Bladder cancer is an important public health problem in Egypt which constitutes 30% of all cancers. Cytology could serve as an excellent test for screening but it is of lower sensitivity. Early diagnosis is critical for maximizing the cure rate of bladder cancer patients, so many urine-based tumor markers have been developed for use in detecting and monitoring bladder cancers. Hypermethylation of CpG islands in the promoter regions of RAR?2 tumor suppressor gene is a major event in the origin of many cancers. In the present study detection of methylated RAR?2 gene was done in the urine of 183 subjects including normal, benign and malignant cases using MS-PCR technique. Results revealed marked urinary RAR?2 promoter hypermethylation in malignant group as compared to benign and normal groups. The sensitivity of detection of RAR?2 promoter hypermethylation was (83.6%) and the specificity was (89.7%), while the sensitivity of urine cytology was (52.2%). Combined use of detection of urinary RAR?2 promoter hypermethylation with urine cytology increased the sensitivity of cytology from 52.2% to 89.5%.