Abstract: Urinary bladder cancer is the most common malignant tumor of the urinary system. Muscle-invasive bladder cancer(MIBC) accounts for 25%-30% of bladder cancer cases. The 5-year overall survival rate in patients with MIBC treated with radical cystectomy alone is low. Neoadjuvant chemotherapy(NAC) combined with radical cystectomy is the standard treatment for localized MIBC. NAC can destroy micrometastasis foci, downstage tumors, and improve the overall survival of patients; however, NAC is only effective in pT≤ T1 patients after chemotherapy. Ineffective chemotherapy may delay patients treatment. How to accurately select patients for NAC is a serious conundrum for clinical workers. This article will review the application status and efficacy prediction of MIBC's NAC.