Abstract: Objective: To investigate the Clinical significance in detection of telomerase activation for the early diagnosis of bladder carcinoma. Methods: TRAP-PCR-ELISA assay was conducted for the presence of telomerase activity in voided urine, bladder washings-exfoliated cells, tissue of bladder cancer and, 20 cases of normal bladder tissue, with 14 cases of non-bladder tumor as control. The urinary exfoliative cytology was conducted. Results: Telomerase activation was detected in voided urine, exfoliated cells and tissue of bladder cancer of the 32 cases. And positive expression rate was 65.6%, 71.9% and 84.0%, respectively. The expression of telomerase activation was negative in 20 cases with normal bladder tissue. One of the 14 cases with non-bladder tumor was positive. The expression of telomerase activation wasn't related to the grades and phases of bladder carcinoma (P>0.05). Conclusions: The detection of telomerase activation is more sensitive and specific than other assays in bladder carcinoma, and would therefore be a good method of early diagnosis.