A 56-year-old man presented with a 1-year history of intermittent gross, painless hematuria. Extensive evaluation revealed primary localized amyloidosis of the urinary bladder. Despite several endoscopic resections and fulgurations, the patient continued to have episodes of significant hematuria due to recurrent amyloid deposition. He was then successfully treated with partial cystectomy. At 60 months following surgery, the patient remains free of recurrent or systemic disease.