Objective To investigate the prognostic value of the controlling nutritional status COUNT score and the Prognostic nutritional index PNI in predicting the prognosis of patients with bladder cancer BC . Method A retrospective analysis was conducted on 360 patients with urothelial carcinoma of the bladder who underwent surgical treatment in the Department of Urology Beijing Chaoyang Hospital Capital Medical University from January 2012 to December 2018. The COUNT score and PNI were calculated for each patient. The Spearman rank correlation test was used to determine the correlation between the two indicators. The Kaplan-Meier survival curve was plotted and the effects of log-rank test univariate analysis and Cox regression multivariate analysis on overall survival OS and tumor-specific survival CSS were evaluated. Result There was a negative correlation between COUNT score and PNI r = -0. 505 P<0. 001 and high COUNT score and low PNI predicted lower survival rate. Meanwhile the Log-Rank test showed that the OS and CSS of patients in the high COUNT score and low PNI group were significantly reduced. Multivariate Cox regression analysis showed that high COUNT score HR = 2. 472 95% CI = 1. 213- 5. 040 P = 0. 013 and low PNI HR = 2. 760 95%CI = 1. 303-5. 848 P= 0. 008 were independent risk factors for OS. High COUNT score HR= 3. 136 95%CI = 1. 417-6. 940 P= 0. 012 and low PNI HR = 2. 619 95% CI = 1. 178 - 5. 825 P = 0. 018 were also independent risk factors affecting CSS. Conclusion There is a significant correlation between the COUNT score and PNI. A higher COUNT score and a lower PNI during the perioperative period are independent risk factors for poor prognosis in BC patients.