Abstract: Objective: To observe the clinical effects of preoperative chemotherapy in invasive bladder cancer.Methods: There were27patients with invasive bladder cancer, with a mean age of 68years (range, 51-85). These patients had an indication for total cystectomy but had not undergone surgery. They were preoperatively treated with intra-internal iliac arterial chemotherapy and embolization. One week later they underwent surgery. The rates of bladder preservation, patho-logic degradation and clinical down-staging, and recurrence of the tumors were observed. Kaplan-Meier analysis was used to calculate the overall survival and disease-free survival rates, and then a survival curve was drawn. Results: After the in -tra-internal iliac artery infusion and embolization, tumor size reduction was seen in 22of the 27patients (81.5%), while no change was seen in the other5. There was tumor down-staging in 21of the total patients (77.8%), but no change in the re-maining6. Pathologic down-grading was observed in 12of the total (44.4%), and there was no change in the other15. The bladder was preserved in 24of 27patients (88.9% ), of which TURB was performed in21, partial cystectomy was per -formed in 3, and radical cystectomy was performed in 3. The 1-, 2-, 3- and 5-year relapse rates were 14.8% (4 patients), 25.9% (7 patients),40.7% (11patients) and 51.9% (14patients), respectively. Distant metastasis and death occurred in 2 cases during the follow-up period at 11and 23months. After surgery 1 case had local recurrence. Following the local exci -sion, the patient survived with a portion of tumor remaining and then died with progression of the disease (PD) 3 years lat -er. Two adenocarcinoma patients died within 5 years due to PD. The 1-, 2-, 3- and 5- year disease free survival rates were 88.9%,73.6%,58.1% and 41.4% respectively, in the27patients, with an overall 5-year survival rate of 66.0%.Conclusion : It is feasible to perform comprehensive measures such as preoperative intra-internal iliac artery infusion chemotherapy, em -bolization and surgery for invasive bladder cancer in selected patients. However, further research is still needed to deter-mine the clinical value of treating invasive bladder carcinomas in this manner.