A 5-year-old African American male patient, with a history of complex vascular anomalies, underwent treatment for an infiltrating urinary bladder malformation initially misdiagnosed as a rhabdomyosarcoma. Neodymium:yttrium-aluminum-garnet laser was used to treat the bladder wall before surgical resection. Vascular malformations of the bladder are rare. This report demonstrates a multimodal technique for management of large infiltrating bladder venous and lymphatic malformation. At the 3-month follow-up, his symptoms have resolved and his cystoscopy demonstrated no evidence of residual disease.