Abstract: Muscle-invasive bladder cancer ( MIBC ) refers to the bladder cancer with clinical stage cT2-cT4a. Radical cystectomy with pelvic lymph node dissection is considered as the gold standard treatment for MIBC, but the 5-year survival after cystectomy varies widely. Neoadjuvant chemotherapy could improve the 5-year survival of MIBC. This article reviews the optimal chemotherapy regimens, current status and future issues of the neoadjuvant chemotherapy.