Carcinosarcoma of the urinary bladder is a rare neoplasm that is histologically composed of malignant epithelial and mesenchymal components. The etiology of sarcomatoid tumors is unclear, but smoking and history of previous radiotherapy or chemotherapy may lead to bladder disorders and to the formation of sarcomatoid carcinoma. These neoplasms behave as highly aggressive tumors and optimal treatment is uncertain. Herein, we report a case of sarcomatoid carcinoma of urinary bladder presenting as a giant intravesical mass in a 61-year-old man complaining of macroscopic hematuria.