Objective: The objective of this article is to review the 10-year clinical outcomes of radical cystectomy (RC) for the treatment of localised bladder cancer from a major Australian metropolitan urology unit. Material and methods: A retrospective analysis identified prognostic factors that contributed to survival outcome in the 120 patients that underwent RC between 1998 and 2008. Patients with benign disease of the urinary bladder (n = 10) and those with inadequate follow-up information (n = 11) were excluded. Results: Complete data were available for 99 patients. The five-year survival for pT1, pT2, pT3 and pT4 was 36 , 47 , 22 and 0, respectively. Lymphadenectomy was not routinely performed as part of RC early in the study period. Multiple surgeons were involved in the cystectomy program. Conclusion: Long-term outcome of RC was considerably different from other published cystectomy series. Postulated reasons include: delay to surgery, surgeon/unit volume and underuse of pelvic lymphadenectomy and neoadjuvant chemotherapy. The establishment of a bladder cancer registry as well as practice guidelines are needed to improve future outcomes. ? British Association of Urological Surgeons 2014.