Hans Goethuys,1 Hein Van Poppel1,21Department of Urology, Ziekenhuis Oost-Limburg, Genk, Belgium; 2Department of Urology, University Hospital Leuven, Leuven, BelgiumAbstract: Muscle-invasive bladder cancer is a deadly disease for which a number of new approaches have become available to improve prognosis. A recent review emphasized the importance of timely indication of surgery and highlighted current views regarding the adequate extent of the surgery and the importance of lymph node dissection. Furthermore, treatment using neoadjuvant and adjuvant systemic chemotherapy has become more prominent, while cystectomy and diversion should be conducted only in experienced centers. Optimal methods of urinary diversion and the use of robot-assisted laparoscopic cystectomy require further study.Keywords: bladder cancer, surgery, chemotherapy, urinary diversion