Cutaneous metastases from urothelial carcinoma of the bladder are a rare disease. In previous reports, the most common metastatic cutaneous lesions were non-tender nodules on the abdominal skin. We report a patient with bladder urothelial carcinoma with cutaneous metastases initially presenting as right leg and suprapubic lymphedema. Bladder tumor was the incidental finding by magnetic resonance venography. Urothelial carcinoma (clinical stage IV) was diagnosed, and chemotherapy was performed. Extensive painful erythematous plaques with an erysipelas-like appearance located on the suprapubic area, chest and abdomen were noted, and cutaneous metastases were confirmed by histopathology. Subsequently, extensive scrotal and prepuce ulcerative changes developed. This paper reports a rare case of extensive cutaneous metastasis of bladder urothelial carcinoma who presented an interesting clinical course.