Urinary bladder cancer is a major epidemiological problem that continues to grow each year, therefore, its early detection and diagnosis reduces the mortality rate and so the morbidity. Urinary bladder cancer (UBC) is the seventh most prevalent type of cancer worldwide.[1] Approximately fifty percent incidences of bladder cancer occur due to cigarette smoking and the remaining large portion, suffers due to their exposure to numerous industrial and/or agricultural carcinogens. These carcinogens induce multiple genetic changes which result in morphological changes and altered cellular metabolism in urothelium. This has prompted us to analyze tissue HRMAS metabolic profiling of patients suffering from non-muscle invasive bladder cancer with the aim of: (i) obtaining information about significant alterations in metabolic composition of tissues of bladder cancer patients from the controls and; (ii) its effect on surrounding biofluid (urine) metabolic composition for exploring the cancer cell related biochemical processes. The current study is a prospective HR MAS spectroscopic study of superficial urinary bladder cancer along with its histopathology. Tissue specimens (n =54) were obtained from patients who were enrolled with a written consent to participate in the study that was approved by the ethics committee at King George’s Medical University, Lucknow. Tissue samples comprising of tumor and mucosa of urinary bladder (which seemed normal) of same patient were obtained from each patient. All these tissue samples were stored in cryo-vials and snap-frozen in liquid Nitrogen at the time of surgery, to stop all the enzymatic and consequent metabolic activities and were then stored at –80°C till the NMR experiments were performed. The NMR experiments were performed at 80 C on a Bruker Fallandan Switzerland 400 MHz FT NMR spectrometer equipped with a 4mm 1H/13C HR-MAS dual probehead. After spectroscopic analysis, the same tissue specimens were subjected to histopathological examination. After phase and baseline correction, the spectra was binned into rectangular buckets of 0.01 ppm from 0.50-4.78 ppm after excluding the chemical shift region observed for the intense glycine signal at 3.56 ppm as glycine solution is being purged prior to the surgery. The binned data was subjected to unsupervised Principal Component Analysis(PCA) followed by Partial least square Discriminant Analysis (PLS-DA) using full validation method using ‘The Unscrambler X’ Software package (Version 10.0.1, Camo ASA, Norway).NMR spectra of transitional cell carcinoma of urinary bladder correlate well with histopathology along with significant variations from the benign ones (Figure 1). The PCA afforded clear differentiation of the malignant and benign groups with an explained variance of 72.30% (Figure 2a). The signals arising due to taurine were visually observed in a significant proportion in 100% of all urinary bladder cancer cases. In addition to taurine resonances, creatine, choline containing compounds, myo-inositol and lactate are significantly found to increase as shown in Figure2 (c) loading plot. The supervised PLS-DA model generated was robust with good predictive capabilities (R2=0.93 and Q2= 0.85) (Figure 2b).Various mutations and gene expression modifications result into altered biochemical balance of metabolites in cancer cells. A common feature of this imbalance is the accumulation of lactate in tumour tissues due to high rates of glucose catabolism and Warburg effect. One of the hallmarks of cancer cells is aberrant membrane choline phospholipid metabolism (MCPM) leading to altered levels of choline-containing metabolites which is found to increase in UBC tissues as in varieties of other tumor cells and tissues. Taurine which is an indicator of cell proliferation was also found to be present significantly in malignant UBC tissue specimens as well. This has been reported earlier by us in urine samples of non- muscle invasive UBC.[2] The study accorded results which were in contrast with the earlier work conducted on Bladder cancer tissue specimens [3] where levels of the triglycerides were found to be significantly lower in benign tissues. This may be because this study was conducted on non-muscle invasive tissue specimens and their histopathologically proven benign surrounding margins. This may be attributed to the possibility of field cancerization. Taurine may be used as a fingerprint biomarker in conjunction with clinical and radiological findings, non-invasively in UBC. However, substantial sample size is required in order to prove our findings.