Primary small cell neuro-endocrine carcinoma is rare malignancy in urinary bladder. We report a case of 57-years-old male presenting with history of haematuria and dysuria for 2 months. Transurethral resection of bladder tumor (TURBT) was performed. Histopathologic examination showed poorly differentiated small cell carcinoma (SmCC) with neuroendocrine differentiation, infiltrating the muscle tissue. Due to presence of gross hematuria and deterioration in general condition, patient received haemostatic palliative external beam radiation therapy (EBRT) followed by adjuvant chemotherapy with cisplatin/ etoposide after resolution of hematuria. Patient died after 4 months of diagnosis of malignancy despite treatment due to aggressive nature of malignancy.