We conducted a case-control study to evaluate the effects of occupation, smoking, and alcohol consumption on bladder cancer risk. A total of 823 male cases and 2,469 age-matched controls were identified through the Missouri Cancer Registry. Relative risk estimates of 2.0 or greater were observed for janitors and cleaners, mechanics, miners, and printers. Current cigarette smoking was associated with a two-fold excess risk of bladder cancer, whereas alcohol consumption showed no association with bladder cancer risk.