In conclusion, this study can conclude that age, history of diabetes mellitus, history of hypertension, pre‐operative hydronephrosis, high T‐stage, presence of lymph node metastasis or regional extra‐lymph node metastasis, combined LVI, high Ki‐67 expression, low PNI, and high NLR were prognostic influencing factors affecting post‐operative RC in patients with MIBC; among them, age, pre‐operative hydronephrosis, high T‐stage, combined LVI, low PNI, and high NLR were independent risk factors affecting OS after RC in patients with MIBC. Here, MKI67 is linked to hydronephrosis.