Objective To examine the hypothesis that increased monocyte tissue factor (mTF) levels may reflect urological tumour presence and progression, Patients, subjects and methods Using a two-stage kinetic chromogenic assay, mTF levels were measured in 60 controls (normal subjects [60] and patients awaiting hernia repair or cholecystectomy [60]), patients with benign and malignant disease of the bladder (73), or prostate (sl), and in patients with and without recurrent malignant disease of the bladder (30), The levels were assessed under fresh resting conditions (baseline) and after incubation for 6h without (unstimulated) and with (stimulated) Escherichia coli endotoxin, Each benign disease group a as subdivided into inflammatory and non-inflammatory categories, Results Patients with bladder and prostate malignancy showed significantly higher mTF levels than did each control for baseline and stimulated cells. The benign inflammatory groups for both organs had significantly higher mTF levels than had each control for baseline cells. There a as no difference between malignant and benign inflammatory groups. Stimulated mTF levels showed better discrimination between the study groups, The mTF levels were associated with histological tumour progression, serum prostate specific antigen level and static bone scan images, Levels were also higher in patients with bladder cancer recurrence than in those with a normal check cystoscopy. Conclusion Stimulated mTF levels are raised in malignant and inflammatory disease compared with controls and patients with non-inflammatory conditions, and give maximal discrimination between these groups, mTF levels showed an association with tumour grade and other markers of tumour progression.