<strong>Background:</strong> Bladder cancer is a common cause of morbidity and mortality in our institution due to the late presentation. Morbidity is defined as a development of complications that may lead to mortality. Uraemia is a common presentation that constitutes a management challenge in our patients. We study the spectrum of morbidity and mortality in bladder cancer patients in our institution. <strong>Materials and Methods:</strong> This is a retrospective study of patients with clinical, radiological, cytological and or histological features of bladder cancer that had a morbidity and or mortality managed at Usmanu Danfodiyo University Teaching Hospital Sokoto from January 2011 to December, 2017. Data were retrieved from patients’ case notes via a proforma and analyzed using SPSS 20.0 version for windows. The results were presented in number percent, tables and chart. <strong>Results:</strong> There were morbidity and or mortality in 234 bladder cancer patients within the study period with a mean age of 48.4 ± 14.1 years and a range of 3 - 106 years. There were 219 males (91.5%) and 20 females (8.5%) with a male to female ratio of 11:1. There were haematuria and lower urinary tract symptoms (LUTS) in 230 patients (98.3%). There were necroturia ± weight loss and anorexia in 126 patients (53.8%). There was urinary tract infection (UTI) in 75 patients (32.1%), anaemia in 131 patients (56.0%) and uraemia in 161 patients (68.8%). Mortality was recorded in 84 patients (35.9%) which was due to uraemia in 52 patients (22.2%), urosepsis in 22 patients (9.4%) and anaemia in 8 patients (3.4%), intestinal obstruction and blood transfusion reaction in 1 patient each (0.4%). <strong>Conclusion:</strong> Anaemia, urosepsis and uraemia are the most common causes of morbidity and or mortality in bladder tumour patients in Sokoto. This poses great diagnostic and therapeutic dilemma to the urologist, patients and their relatives.