Survival time of bladder cancer combined with pelvic lymph node metastasis is related to patients’ physical fitness and disease severity, which cannot be accurately judged, and some studies claimed that the 3-year overall survival rate of this type of patients is 50%. Bladder cancer is the fourth most common malignant tumor among men and the eighth most common malignant tumor among women. Clinical manifestations include intermittent painless hematuria, urinary tract irritation and urinary difficulty, and in late stage, peripelvic infiltration and distant metastasis may occur, which will lead to corresponding clinical symptoms. Bladder cancer combined with pelvic lymph node metastasis suggests that it has already spread and metastasized, which suggests that the prognosis is relatively poor, but it can be treated by comprehensive therapy such as surgical resection combined with lymph node dissection, radiotherapy, chemotherapy, and targeted therapy, which can improve the quality of patients’ life and prolong their survival time. According to some studies, the prognosis of patients with bladder cancer combined with pelvic lymph node metastasis is closely related to pathological stage, pathological type, age, etc. The overall survival rate of patients with pelvic lymph node metastasis in 3 years is 50%. Bladder cancer patients should pay attention to it. If bladder tumor is suspected or diagnosed, it is recommended to go to regular hospitals for comprehensive assessment of the condition, follow the doctor’s instructions to cooperate with the treatment, and choose the appropriate treatment plan to avoid delaying the condition.