Malakoplakia is regarded as a chronic granulomatous infl ammatory disease with a good prognosis. It usually aff ects the urinary system, especially the urinary bladder. Bacterial infections, including E. coli are thought to be the main factor in pathogenesis. It frequently coexists with chronic diseases and immunosuppression state. Histopathological examination of aff ected tissue samples is thought to be the best diagnostic method. Th e basic microscopic feature is mixed infl ammatory infi ltration containing foamy histiocytes known as von Hansemann cells, frequently with basophilic inclusions known as Michaelis-Gutmann bodies. Symptoms and the clinical course of malakoplakia depend on location and the extent of the lesions. Th e lesion is treated successfully with antibiotic therapy and surgical excision.