Introduction. Clitoral metastases are exceptionally rare. We present a case of a squamous cell carcinoma of the bladder presenting with a clitoral metastasis. Case Report. We report the case of an 84-year-old lady with frequency, dysuria and a clitoral mass, which was found to be a poorly differentiated carcinoma on fine needle aspiration cytology. Cystoscopy revealed a moderate to poorly differentiated squamous cell carcinoma of the bladder. Conclusion. This is the first reported case of a squamous cell carcinoma of the bladder with clitoral metastasis. Clitoral metastases are exceptionally rare, with only seven previous cases reported in the literature. Although the commonest cause of cliteromegaly is hormonal, a metastatic carcinoma should be considered as part of the differential diagnosis in the elderly female. (C) 2004 Elsevier Inc. All rights reserved.