Background: Trimodality treatment of muscle invasive bladder cancer (MIBC) has a comparable effect to radical cystectomy with maintain of bladder function. Neoadjuvant chemotherapy before definitive treatment either surgery or radiotherapy is a state of art nowadays. Patients and methods: We targeted sixty patients with locally advanced bladder cancer who weren’t candidate for radical cystectomy. Patients received 2 to 3 cycles of Induction chemotherapy based on platinum compound (either cisplatin or carboplatin) according to renal function in combination with gemcitabine followed by definitive radiotherapy 66 Gy (2 Gy per fraction) concurrent with weekly platinum compound in two phases. Results: The age of patients had a median of 67 years. T3 was the most presenting stage in 68.3% of patients. Forty- eight patients had a clinical positive LN, while 38 patients had grade 3. 73.3% of patients received 3 cycles of NA chemotherapy. 49 patients (81.6 %) received full dose of planned radiotherapy dose, while weekly concurrent chemotherapy was administrated in 95% of patients. Complete response was achieved in 26 patients (43.3 %). After a median follow up period of 16 months, 2-year progression free survival (PFS) was 27.1 % and 2 –years overall survival (OS) was 52.3%. PFS and OS were statistically significant differ in grade 2 vs. grade 3 (p=0.002, p=0.001), tumour size T2 vs. T3 and T4 (p=0.003,p=0.043) and nodal status clinical negative LN vs. clinical positive LN (p=0.02,p=0.006),respectively. Sex and type of chemotherapy had no effect on survival. The toxicities were acceptable. Conclusion: Neoadjuvant chemotherapy before definitive CRT is feasible and provides acceptable results and tolerable toxicities in locally advanced bladder cancer patients who radical cystectomy isn’t suitable for them.