Aim: The purpose of this study is to evaluate the diagnostic usefulness of combining cystoscopy and urine cytology in the diagnosis of urothelial neoplasia. Material and methods: One hundred patients with hematuria from the urology outpatient department and the inpatient ward were recruited for the research. These patients might be of any age or gender. Individuals who had a history of prostatism, abdominal mass, urinary tract infection, anorexia, or weight loss, as well as proteinuria, were not allowed to participate in the trial. Results: Urine cytology results were scored, and cases were ranked from 0 to 5 on a scale from most severe to least severe. Throughout the course of our research, there were seven individuals who fell into category 0 (Inadequate or no specimen), since their smears had only a small number of degenerated cells and did not have a sufficient number of urothelial cells. Patients fell into group 1 in 73 (73%) of the cases (benign). No cases met the criteria for category 2 (atypical probably benign), 3 (3% of patients) patients met the criteria for category 3 (atypia of uncertain significance), 6 (6% of patients) patients met the criteria for category 4 (atypia suspicious of malignancy), and 11 (11%) patients met the criteria for category 5 (atypical possibly malignant) (malignant). The degree of agreement between cytology and cystoscopy was quite low. Conclusions: Even though it has poor sensitivity, urine cytology is nevertheless a valuable test for the detection of bladder malignancies. Cytology is a useful adjunct to cystoscopy since the two procedures target distinct kinds of lesions when done effectively. In the event that urothelial neoplasia is suspected, both procedures need to be finished.