Carcinosarcoma (CS) of the bladder is a rare malignancy of the genitourinary tract that is highly aggressive with unfavorable prognoses. Data regarding the epidemiological and clinicopathological characteristics of CS of the urinary bladder have been limited due to the low reported incidence of the tumor. In particular, there is little evidence on recurrence patterns and surveillance after definitive surgical therapy. In this case report, we describe a urethral recurrence of CS after radical cystoprostatectomy for CS of the bladder. The goal of this case report is to review our current understanding of the pathological and recurrence patterns of patients with CS of the urinary bladder in order to better define postoperative care for patients with CS of the bladder.