Primary bladder adenocarcinoma is a rare tumour which represents between 0.5% and 2% of malignant bladder tumours. The incidence of malignant tumours is increased in renal transplant recipients. The combination of primary bladder adenocarcinoma and renal transplantation is exceptional. The authors report a case of primary bladder adenocarcinoma in a 34-year-old patient who had undergone renal transplantation 5 years previously. In the light of this case, the authors discuss the various cases reported in the literature and the specific management of this rare tumour.