299 Background: Notch signal pathway plays a fundamental role in mediator of tumorigenesis, either as a tumor promoter or suppressor, depending on cellular context and expression levels; we investigated the prognosis of invasive bladder transitional cell carcinoma patients with over-expression of Notch-1. METHODS Tumor tissue samples from 78 resected patients with invasive bladder transitional cell carcinoma were obtained, and immunohistochemistry was used to evaluate the expression of the molecular markers Notch-1 and Jagged-1. To further confirm the immunohistochemical results tissue samples were subjected to RT-PCR and Western blot analysis, staining evaluation results were analyzed statistically in relation to various clinicopathological characters. Kaplan-Meier and Cox proportional hazards regression methods were used to assess associations of Notch-1 expression with invasive bladder transitional cell carcinoma survival. RESULTS Survival time in patients with high expression of Notch-1 and Jagged-1 was significantly shorter than that in patients with low expression p=0.009 and more recurrence p=0.01, in multivariate analysis, Notch1 expression was proved to be an independent predictor of prognosis; (hazard ratio Notch-1 was 1.93 (95% CI, 1.02-3.03; P =0.014), expression was not related to patient sex or age. CONCLUSIONS Notch-1 expression is associated with tumor progression, indicating that Notch-1 may be involved in the carcinogenesis and progression of invasive bladder transitional cell carcinoma. These findings also suggest that Notch-1 may be a potential diagnostic marker and therapeutic target in patients.