Mesenchymal neoplasms of the bladder and male genital tract are uncommonly encountered in routine diagnostic practice and present diagnostic challenges. Here, I systematically survey mesenchymal tumors at each body site, including the spermatic cord, scrotum, and perineum. I provide a detailed overview of tumor types that specifically or most commonly occur in the bladder and male genital tract, including pseudosarcomatous myofibroblastic neoplasm of the bladder, proliferative funiculitis, paratesticular sclerosing rhabdomyoma, penile myointimoma, and so-called prostatic stromal tumors.