Background: Bladder cancer is the most frequent urologic cancer, with the greatest recurrence rate of any cancer. Urothelial carcinoma is the most prevalent kind. Aim: The goal of this prospective study is to assess the efficacy and safety of concomitant intravesical gemcitabine with radiotherapy in non-metastatic muscle-invasive urothelial bladder cancer. Patients and Methods: Following investigations and complete or incomplete transurethral resection, all patients will be collected. Two groups of patients will be evaluated. Group 1 patients will receive 1000mg of gemcitabine in 50ml of saline once a week for one hour at the start of the seven-week treatment period, and radiotherapy will be administered at 59.4 Gy/33 treatment/6.5 weeks. Group 2 patients will receive the same radiotherapy dose of 59.4 Gy/33 treatment/6.5 weeks. Results: Evaluation of both groups regarding the RECIST Criteria after eight months, 16 patients from 27 patients (59%)with a complete response to chemoradiotherapy group while 5 patients from 30 patients(16.6%) with the complete response at radiotherapy group, 6 patients(22.2%) with good partial response in the Chemo-radiotherapy group but 9 patients (30%) in the radiotherapy group, 3 patients (11.1%) were with stable disease in the chemo-radiotherapy group but 7 patients (23.3%) in the radiotherapy group, and 2 patients (7.4%) were presented with progressive disease at Chemo-radiotherapy group in comparison to 9 patients (30%) at Radiotherapy group. Conclusion: Concurrent intravesical gemcitabine-based chemoradiotherapy has a high response rate in muscle-invasive urothelial bladder cancer, as well as long-term local control and low toxicity, allowing patients to keep their own bladder.