The multiplicity of bladder diverticula is well documented, yet review of the literature revealed only one reported case of cancer occurring in more than one diverticulum. To our knowledge, we report on the first long-term follow-up of a remaining bladder diverticulum after partial cystectomy for a transitional cell carcinoma in a contralateral diverticulum. The case report suggests that conservative management may be preferred for bladder diverticula not involved with tumor and routine prophylactic diverticulectomy may not be necessary.