Soft tissue sarcomas account for approximately 6% of child-hood cancers and almost 50% of these are rhabdomyosar-comas, a highly malignant tumor developing from skeletal muscle cells that have failed to fully differentiate.1 Following neuroblastoma and Wilms tumor, rhabdomyosarcoma is the third most common extracranial solid pediatric malignancy. Fifteen to 20% of rhabdomyosarcomas emerge from the genitourinary system and sites include prostate, bladder, and the paratesticular region. Rhabdomyosarcoma can be gener-ally divided into two main histological subsets: alveolar and embryonal. Usually, the incidence of alveolar rhabdomyo-sarcoma is higher during adolescence, whereas embryonal rhabdomyosarcomas are more common during early child-hood.2 Botryoid and spindle cell rhabdomyosarcoma consti-tute less common variants of embryonal rhabdomyosarcoma with a superior prognosis.2 With this case report, we aimed to delineate a therapeutic decision-making process in a boy presenting with rhabdomyosarcoma of the bladder consider-ing the most contemporary therapy options.