Objective Dynamic detection of urinary Livin mRNA expression in patients with bladder cancer before and after operation and its clinical value in early diagnosis of bladder cancer. Methods Urine of 30 patients with initially diagnosed BTCC was collected before operation and one week, one month, three months, six months and 18 months after operation. Urine of 30 healthy volunteers and 30 Non-urological cancer patients was collected. Expression of survivin mRNA in urine exfoliated cells was detected by real-time PCR. Results Livin mRNA was highly expressed in the urine of 30 patients before operation, and the relative copy number was (96.33±35.79), and the expression level increased with the clinical stage and grade of the tumor from low to high; 2 of 30 patients in the control group showed high expression, the relative copy number was 43.17 and 47.52, the other was low expression, and the expression level was low. The copy number was (16.25±7.81); 30 cases in normal group were low expression, and the relative copy number was (13.74±1.57). The expression of Livin mRNA in urine of the case group was significantly higher than that of the control group and the normal group (P<0.05); the expression of Livin mRNA in urine of the case group was significantly lower than that of the control group (P<0.05); the expression of Livin mRNA in urine of the case group was significantly lower than that of the normal group (P<0.05); there was no significant difference between the control group and the normal group (P>0.05). Follow-up to 18 months after surgery, 5 patients with recurrence before reoperation (98.27±26.55) and 6 months after the initial operation were significantly different (P<0.05). Conclusion Dynamic detection of urinary Livin mRNA expression with high specificity and sensitivity can be used as an important noninvasive marker for early diagnosis of bladder cancer.