Context and objective Schistosomoses or bilharziasis constitute the second world parasitic endemia after malaria, the objective of our study was to generally study urinary bilharzia at the Markala reference health centre. Patients and methods: It was a transversal and descriptive study carried out in the Markala reference health center on the cases of urinary bilharzoses diagnosed and treated on the basis of paraclinical investigations over a period of 29 months from January 2019 to June 2021. At the end of this study, it appears that 62 cases of urinary bilharziosis had been diagnosed, including 19 associated tumours. The average age of our patients was 28 years, with extremes ranging from 04 to 75 years. Male sex was most represented with 48 cases or 77.4%. The bambaras were the most affected ethnic group or 43.5% with a clear provenance of the Markala district (43.5%). We recorded 18 cases of chronic kidney failure, 29%, followed by chronic cystitis (19.4%). The radiological aspects of sequelae of the most found uro-genital bilharzia were: bladder tumors with 67.7%; Calcifications (ureteral and bladder) represented 32.3%; and Bilharzian cystitis (40.32%). Calcifications (ureteral and bladder) according to the topography were noted respectively 22% and 10.3%. Conclusion: A real public health problem Bilharziasis occupies second place in parasitic conditions in Mali. It represents a real obstacle to economic development because touching the most active age of the population. The paradox of bilharziasis is that, the irrigated areas, fitted out to ensure food self- sufficiency and hydroelectric dams contribute to the progression of the Bilharzian infestation.