Apoptosis is a morphologically and biochemically distinct form of cell death which determines specific patterns of tissue size and shape and balances cell proliferation. In the present study, the sequence of cellular proliferative alterations in urinary bladder epithelium associated with uracil-induced reversible urinary calculi was investigated in male F344 rats. Group 1 consisted of 45 rats, 6 weeks old at commencement of the experiment, which were given a diet containing 3% uracil for 8 weeks and were then returned to basal diet until week 20. Five rats were killed at each of weeks 2, 4, 8, 9, 10, 11, 12, 14 and 20. Group 2 consisted of 15 rats which were given basal diet for 20 weeks. Five rats were killed at each of weeks 0, 8 and 20. Microscopic, reversible papillomatosis, which showed papillary projections of epithelial proliferation, was seen in the urinary bladder of all rats in group 1 through week 8. No epithelial lesions were apparent in any of rats in group 2. Anti-Le(y)(BM-1/JIMRO)-positive areas of the urinary bladder epithelia were immunohistochemically seen in all rats of group 1 at weeks 2-12. At week 9 the percentage of anti-Le(y)-positive areas reached a maximum. Nick-end labeling stained nuclei of cells in the urinary bladder epithelium were observed in all rats of group 1 at weeks 4-14. At week 10 the labeling index was at a maximum. Proliferating cell nuclear antigen (PCNA)- and cyclin D1-positive cells of the urinary bladder epithelium were observed in group 1 at weeks 2, 4 and 8, however, at week 9 there were no PCNA- and cyclin D1-positive cells. In urinary bladder papillomatosis the simultaneous existence of apoptotic cells and proliferating cells was shown by double staining with anti-Le(y) (BM-1/JIMRO) and for PCNA. At week 10 apoptosis, stained by BM-1 and nick-end labeling, occurred extensively in regressing urinary bladder papillomatosis. Agarose gel electrophoresis of DNA in regressing papillomatosis at week 9 showed DNA fragmentation. Thus, these results indicate that apoptosis occurs in the process of papilloma regression following withdrawal of uracil treatment.