Bac kgro und The laparoscopic radical cystectomy (LRC) with orthotopic ileal neobladder is now applied to t reat invasive bladder cancer, however, it has not been well codified and illust rated. We describe in this paper a technique step by step that we have developed in 33 patient s and achieved excellent result s. Methods The surgical procedure can be divided into eight steps: laparoscopic pelvic lymphadenectomy and mobilization of the distal ureters; exposing Denonvillier's space and the posterior aspect of prostate; exposing ret ropubic space and anterior surface of the bladder; dividing the lateral pedicles of the bladder and the prostate; dividing the apex of the prostate; ext racorporeal formation of the ileal pouch; ext racorporeal implantation of the ureters; and laparoscopic urethra-neobladder anastomosis. This operation was performed in 33 patient s, 29 males and 4 females, with muscle invasive bladder cancer between December 2002 and September 2004. Results The operating time was 5.5-8.5 hours with an average of 6.5 hours; the estimated blood loss was 200-1000ml with an average of 460ml. The surgical margins of the bladder specimen were negative in all patients. There was no evidence of local recurrence at follow-up of 1-21 months in all the patient s. However lymph node metastases were found in one case at 9 months postoperatively. Most of patient s achieved urine cont rol 1 to 3 months after surgery. The daytime continence rate was 94% (31 cases) and nighttime continence rate was 88% (29 cases). Urodynamic evaluation was performed between 3 and 6 months postoperatively for all cases. The mean value of neobladder capacity was (296