Objective To investigate the bladder cancer radical cystectomy with orthotopic ileal neobladder surgery clinical therapeutic effect. Methods 25 cases of bladder cancer patients using total cystectomy and orthotopic ileal neobladder surgery were retrospectively reviewed the clinical data analysis. Results All patients were successfully completed operation therapy, postoperative follow-up of patients with no recurrence, daytime urinary continence in patients with good accounted for 94%, nocturnal urinary continence good accounted for 84%.Urinate unobstructed accounted for 21 cases, unsmooth accounted for 4 of cases; by B ultrasound examination, no dilatation of the upper urinary tract symptoms, cystography revealed no vesicoureteral reflux phenomenon appears. Conclusion Radical cystectomy with orthotopic ileal neobladder surgery was applied in the treatment of bladder cancer have a significant clinical effect, is an ideal treatment method, and should be widely applied clinically and promotion.