Objective To evaluate the efficacy and safety of a novel continuous irrigation sheath for flexible cystoscope in improving the vision and patient compliance of flexible cystoscopy under hematuria. Methods A total of 32 male patients, who received flexible cystoscopy for hematuria in our hospital, were evenly randomized into two groups. Patients in group A received flexible cystoscopy with the help of the novel continuous irrigation sheath; while patients in group B received traditional flexible cystoscopy. The vision score of flexible cystoscopy and visual analog pain score were recorded in the two groups. Results The flexible cystoscopy was smoothly conducted in the two groups. The operation time in group A was significantly shorter than that in group B (\[7.50±1.59\] min vs \[9.81±2.56\] min, P<0.05)；the vision score of flexible cystoscopy in group A was significantly better than that in group B (\[2.75±0.45\] vs \[1.56±0.63\], P<0.05).And there was no significant difference in visual analog pain score between the two groups (\[2.00±0.89\] vs \[1.93±1.12\], P>0.05). Conclusion The novel continuous irrigation sheath can effectively improve the vision of flexible cystoscopy without increasing discomfort to patients.