Abstract: Objective To explore the value of urine bladder cancer associated protein-4 (BLCA-4) in the diagnosis and detection of the recurrence of different stages of bladder transitional cell carcinoma (BTCC). Methods Between January, 2016 to November, 2017, 50 cases of bladder cancer, 40 healthy individuals and 40 cases of bladder stones in our hospital were enrolled into this study. ELISA was used to detect the levels of BLCA-4 and BLCA-1 in the urine of the subjects in all the three groups. The difference in the expression of BLCA-4 and BLCA-1 between recurrent bladder cancer patients and other patients without recurrent cancer was compared. Results The levels of BLCA-4 and BLCA-1 in the bladder cancer group were higher than those of healthy group and bladder calculi group; and the levels of BLCA-4 and BLCA-1 in patients with metastasis to lymph nodes and distant organs were significantly higher than other patients without metastasis to lymph nodes and distant organs. The sensitivity and specificity of BLCA-4 for the diagnosis of bladder cancer were 84% and 94%, and those of BLCA-1 were 86% and 92%, respectively. The levels of BLCA-4 and BLCA-1 in the patients without recurrent cancer decreased obviously one year after the operation, but in the patients with recurrent cancer increased significantly, the difference was significant (P<0.05). Conclusion BLCA-4 and BLCA-1 are sensitive to the diagnosis of bladder cancer and may be a new tumor marker for BTCC screening and postoperative follow-up.