This paper analyzes in detail different surgical approaches in the treatment of muscle invasive bladder cancer (MIBC), which represents a significant health challenge given its prevalence and potentially serious consequences. Bladder cancer is the second most common cancer of the urinary tract, and over 90% of cases are of urothelial origin. Its main causes include factors such as smoking, chemical exposure, chronic cystitis, heavy metals and ionizing radiation. It is important to note that bladder cancers can be classified as non-muscle invasive or muscle invasive, with the latter accounting for about 20% of all diagnosed cases. Diagnostic procedures include various urine analyses, such as biochemical, microbiological and cytological analyses, as well as the use of various imaging methods such as cystoscopy, ultrasound, CT and MR imaging. Definitive diagnosis is established by transurethral resection (TUR) or biopsy. Surgical treatment of MIBC includes transurethral resection of the urinary bladder (TUR) and radical cystectomy (RC). TUR is used in the early stages of the disease, while RC is reserved for advanced cancer that does not respond to other therapies. RC can be open or laparoscopic, and involves removing the bladder, surrounding tissue and lymph nodes. It is important to emphasize that after RC the urinary system should be reconstructed in order to enable normal urine excretion. Laparoscopic RC is a minimally invasive method that is performed with the help of special instruments. Although laparoscopic RC offers certain advantages such as less bleeding and faster recovery, it is important to note that it requires an experienced surgeon. The choice of treatment method depends on the stage of the disease, the patient's general condition and the patient's preferences. Surgical treatment remains the gold standard in the treatment of MIBC, but requires careful evaluation and tailoring for each patient.