We study localized bulging of a cylindrical hyperelastic tube of arbitrary thickness when it is subjected to the combined action of inflation and axial extension. It is shown that with the internal pressure P and resultant axial force F viewed as functions of the azimuthal stretch on the inner surface and the axial stretch, the bifurcation condition for the initiation of a localized bulge is that the Jacobian of the vector function (P, F ) should vanish. This is established using the dynamical systems theory by first computing the eigenvalues of a certain eigenvalue problem governing incremental deformations, and then deriving the bifurcation condition explicitly. The bifurcation condition is valid for all loading conditions, and in the special case of fixed resultant axial force it gives the expected result that the initiation pressure for localized bulging is precisely the maximum pressure in uniform inflation. It is shown that even if localized bulging cannot take place when the axial force is fixed, it is still possible if the axial stretch is fixed instead. The explicit bifurcation condition also provides a means to quantify precisely the effect of bending stiffness on the initiation pressure. It is shown that the (approximate) membrane theory gives good predictions for the initiation pressure, with a relative error less than 5%, for thickness/radius ratios up to 0.67. A two-term asymptotic bifurcation condition for localized bulging that incorporates the effect of bending stiffness is proposed, and is shown to be capable of giving extremely accurate predictions for the initiation pressure for thickness/radius ratios up to as large as 1.2.