Priapism of the clitoris is a rare entity. A case of painful priapism is reported in a patient who had previously suffered a radical cystectomy for bladder carcinoma pT3-GIII, followed by local recurrence in the pelvis. From a symptomatic point of view she showed a good response to conservative treatment (analgesics and anxiolytics), as she refused surgical treatment. She survived 6 months from the recurrence, and died with lung metastases. The priapism did not recur. The physiopathological mechanisms involved in the process are discussed and the literature reviewed.