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Breast carcinoma is the most common nondermatologic cancer diagnosis in women. Common metastatic sites include lymph nodes, lung, liver, and bone. Breast carcinoma metastatic to the bladder has been reported only sporadically. Most patients were symptomatic breast cancer with evidence of disseminated disease at the time of diagnosis. Metastasis usually occurred many years after diagnosis, and the prognosis was poor. We report a case of breast caricinoma metastasizing to the urinary bladder and retroperitoneum, which presented initially with acute renal failure. Patient was treated with bilateral per cuteneous nephrostomies and chemotherapy. Starting from this clinical case we review the available literature on this issue. Patients with breast cancer presenting with urinary symptoms should be examined for possible bladder metastasis.