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A 50-year-old man with cerebral palsy presented to our department complaining of pollakiuria and macrohematuria. Although urinary cytology revealed no positive findings, computed tomography (CT) showed muscle-invasive bladder carcinoma and right intrapelvic lymphadenopathy (cT3bN1M0). Cystoscopy revealed a large non-papillary bladder tumor. Radical cystectomy and urinary diversion were performed. Verrucous carcinoma (VC) of the bladder without intrapelvic lymph node metastasis (pT3bN0) was diagnosed histopathologically. VC is often locally invasive and is a non-metastasising well-differentiated variant of squamous cell carcinoma. Patients with cerebral palsy have a high incidence of urinary incontinence, dysuria, and urinary tract infections. VC of the bladder is associated with chronic bladder irritation due to various causes, including chronic cystitis, dysuria, and bladder stones. VC is frequently detected as locally invasive disease of stage T3 or higher ; the only effective treatment is radical cystectomy. Therefore, early detection and surgery are necessary to improve prognosis. Clinical evaluation, including urodynamic studies, is recommended for patients with cerebral palsy, and in cases of persistent pollakiuria, dysuria, and macrohematuria, abdominal CT and cystoscopy should be considered for the early detection of squamous cell carcinoma and VC of the bladder.