Introduction: Bladder cancer (BC) is frequently marked by high recurrence and progression rates, making close follow-up essential. Cystoscopy remains the standard method for surveillance; however, it is invasive, costly, and uncomfortable for patients. Given these limitations, there is increasing interest in identifying minimally invasive biomarkers to support clinical management.

Objectives: This study aims to assess the potential prognostic role of the creatinine-to-hemoglobin ratio (CHR) in individuals with BC.

Methods: A retrospective study was performed on 148 patients with BC treated at the Urology Department of Mureș Clinical County Hospital. Patients’ clinical, pathological, and laboratory data were collected. CHR was calculated from routine blood test parameters. The association between CHR and tumor-related parameters was assessed using statistical testing, primarily employing non-parametric methods and Spearman’s rank correlation analysis.

Results: Elevated CHR values were significantly associated with more advanced tumor stages (median CHR: 0.10 in pT2 vs. 0.07 in pTa; p < 0.001), lower hematocrit levels, and higher tumor grades. CHR demonstrated weak but statistically significant correlations with tumor stage (r = 0.274), grade (r = 0.274), and patient age (r = 0.16). No significant association was observed between CHR and tumor size.

Conclusion: As a marker derived from routine laboratory tests, CHR may provide useful information for the assessment of BC patients, particularly those with advanced disease features. CHR appears to be associated with adverse pathological characteristics and may serve as a supportive indicator of disease burden. These preliminary findings emphasize the need for further prospective studies to determine whether CHR could be integrated into existing risk assessment tools and follow-up strategies.