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This case report documents the rare occurrence of axillary metastasis in a patient with a history of typical urothelial bladder cancer. Bladder cancer rarely metastasizes to supradiaphragmatic cutaneous tissues, and this presentation confers a poorer prognosis as well as an association with atypical variants of bladder cancer. However, this paper suggests that typical pure urothelial bladder cancer may be just as aggressive as its atypical counterpart. In addition, the work-up of axillary masses in a patient with a history of bladder cancer, whether typical or variant, should include metastatic disease as part of the differential diagnosis and guide treatment strategies.