Background: Small cell neuroendocrine carcinoma of the bladder (SCNECB) is a rare entity, accounting for less than 1% of bladder tumors. It progresses rapidly and has a poor prognosis. Case Presentation: We report the case of a 62-year-old man, a chronic smoker, admitted for gross hematuria that had been developing for a month. An abdominal-pelvic CT scan revealed an infiltrating bladder mass associated with liver metastases. RTUV confirmed the diagnosis of small cell neuroendocrine carcinoma through immunohistochemistry: chromogranin A, synaptophysin, and CD56 positive, Ki-67 at 80%. The patient received six cycles of cisplatin-etoposide, with an initial partial response. The disease then progressed rapidly, leading to the patient’s death eight months after diagnosis. Conclusion: This case illustrates the early metastatic presentation and rapid progression of small cell neuroendocrine carcinoma of the bladder. Despite platinum-based chemotherapy, the prognosis remains poor, especially in resource-limited countries.
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