Paraganglioma (PG) of the urinary bladder was detected in a 64-year-old male who was admitted to the hospital with gross hematuria. In voided urine, atypical cells were scattered as nests and single cells on low-power view. On higher-power view, tumor nests were composed of epithelioid cells with fine chromatin and moderate cytoplasm admixed with occasional spindle sustentacular cells. Single cells were discohesive and large with moderate cytoplasm and inconspicuous nucleoli. Subsequent cystoscopy revealed a solid oval mass. Histologically, tumor from the resected bladder showed infiltrating nested tumor cells with abundant cytoplasm. Immunohistochemically, the tumor cells were positive for synaptophysin, chromogranin, and CD56. The patient underwent partial cystectomy and was discharged without complications. Diagn. Cytopathol. 2017;45:350–353.