Abstract: Organoids are novel in vitro models that can effectively simulate the complexities of tumor microenvironments. Compared to traditional preclinical models, organoids retain most of the histological and molecular properties of the primary tumor; therefore, they are more useful for studying tumor heterogeneity, underlying functional pathways, and immune microenvironments as well as for research on biomarker discovery, drug screening, and individual chemotherapy. Furthermore, current limitations, challenges such as low modeling success rates, high costs, and lack of standardization are expected to be overcome by continued innovations in bioengineering technologies and interdisciplinary integration. This article reviews the advantages, establishment processes, and prospects and challenges associated with the clinical application of organoids in bladder cancer.