Cystectomy was performed for management of carcinoma of the urinary bladder in a series of 307 patients. Urinary diversion was performed by ureterosigmoidostomy in 78, and ileal loop diversion in 229 patients. A five-year survival rate of 31.0% in the ureterosigmoidostomy series and 36.2% in the ileal loop series was obtained. A surprising number of patients, in whom penetration through the entire bladder wall had occurred, survived the five years (approximately 30%). Simple cystectomy remains a valuable tool in the management of carcinoma of the urinary bladder.