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Leukoplakia is an uncommon diagnosis. Patient usually presents with hematuria (visible and non-visible), dysuria, urgency and frequency. Definitive investigation is rigid cystoscopy. Abnormal bladder wall tissue should be resected and biopsies sent for histopathology to confirm the diagnosis. The condition is said to be pre-malignant it is usually advised to do annual cystoscopy with multiple biopsies is to look for any evidence of malignant transformation. Case Report: We present case report of a 64-year-old male presented to the urology clinic with a hematuria. Cystoscopy revealed a 2-cm white lesion on the right side of the urinary bladder. White plaques were also noted covering some areas of the bladder. Transurethral resection of the lesion and biopsy of the white plaques were performed. Pathological examination confirmed a diagnosis of keratinizing squamous metaplasia of the bladder with no evidence of malignancy. [ABSTRACT FROM AUTHOR]