In Tunisia, bladder cancer represents the first urological cancer before even prostate cancer. However, its diagnosis is often delayed to the stage of invasive tumor. Systemic chemotherapy represents an option for inoperable and/or metastatic forms. Our study's aims were to report our center's therapeutic results for locally advanced and metastatic forms of bladder cancer and to analyze its prognosis factors. In our 40 patients with bladder cancer advanced stages (locally advanced and metastatic), transitional cell carcinoma was the most common histological type (82.5%); mean age at diagnosis was 63.3 ± 10.5 years with a sex ratio equal to 12.3; radical cystectomy and radiation therapy were performed separately both in 35% of cases and chemotherapy in 60%; cisplatin associated with gemcitabine was the most used regimen and navelbine monotherapy was used as second-line chemotherapy; median overall survival was 14.4 months, and its influencing factors according to our results were: ECOG score, T and M tumor stages, primary tumor surgery and adjuvant chemotherapy.