The clinical efficacy of intraarterial neoadjuvant chemotherapy with MTX, ADR and CDDP in 88 patients with advanced bladder cancer (> or = T2 or TCC G3) was evaluated. The intraarterial chemotherapy was performed using Seldinger's method. The three drugs were administered at the same time among 60 patients. In sixteen patients MTX was administered intravenously before intraarterial infusion of ADR and CDDP. In twelve patients, a high dose of CDDP (more than 100 mg/m2) was administered. The mean regression rate was 70%. That of the high-dose CDDP group was rather superior to the other two groups. However, the adverse reaction and duration of recovery were inferior to those of the other two groups. When intraarterial chemotherapy is performed as a neoadjuvant chemotherapy, care must be taken to determine the suitable dose.