Bladder cancer is a carcinoma of the urothelial, or “umbrella,” cells that line the lumen of the urinary bladder. Technically, urothelial carcinoma includes tumors of the bladder, upper urinary tract (renal pelvis and ureters), and proximal urethra. Bladder cancer accounts for approximately 90% to 95% of urothelial carcinoma; bladder cancer comprises 75% pure urothelial carcinoma and 25% “variant” histology, adding complexity to the management of this disease. Bladder cancer can be categorized in several way, almost all bladder cancers originate in the urothelium, which is a 3- to 7-cell mucosal layer within the muscular bladder. Squamous cell carcinoma of the bladder can involve multiple sites; however, the lateral wall and trigone are more commonly involved by this tumor. All small cell carcinomas of the urinary system identified so far have been located in the urinary bladder, most commonly in the dome and vesical lateral wall. Radical cystectomy is a crucial surgical technique in managing MIBC, high-risk NMIBC, and treatment-refractory NMIBC. Despite a high perioperative mortality rate (5-10%), it now carries a 1-2% mortality rate due to improvements in surgical technique, intensive care medicine evolution, and antibiotic availability.