Background: Pure squamous cell cancer of the bladder is uncommon in the United States. Because squamous cell bladder cancer is rare, there are no large studies with details on optimal preoperative neoadjuvant therapies and long-term outcomes. To improve the overall knowledge of the disease this study sought to provide a contemporary update in a single center cohort. Methods: A retrospective cohort study was performed. 57 patients had a radical cystectomy (RC) for pure nonbilharzialsquamous cell bladder cancer between 1995 and 2015. Demographics, risk factors for squamous cell bladder cancer, pathology, and outcomes were reviewed and compared with descriptive statistics. Advanced disease was defined as ≥ T3/T4 disease and any positive lymph node metastasis. Logistic regression was used to identify predictors of overall survival (OS), disease specific survival (DSS) and recurrence free survival (RFS). Kaplan-Meier curves were used for survival prediction. Results: With a median follow up of 24 months (IQR 9.7-131.8 months), 12 (21.4%) had a recurrence. The median time to recurrence was 15.5 months (IQR 5.0-20.0 months). Recurrence was most common in the pelvis, n = 5(62.5%). 20 had neoadjuvant chemotherapy (NAC), 16 of which it was combined with external beam radiation (XRT). 50.8% of patients had advanced pathology. 5-year OS was 59.7%. To predict RFS all of the following were adjusted for: age, stage, advanced pathology, nonbilharzialsquamous cell risk factors, lymphovascular invasion, and number of lymph nodes removed at RC. Predictors of RFS were combined NAC and XRT, pathologic T-stage, advanced disease (p = < 0.01, p = 0.02 and p = 0.02, respectively). Predictors of DSS were pathologic T-stage and node positive disease (p = 0.04 and < 0.01, respectively). OS was best predicted by clinical stage, p < 0.001. Conclusions: The combination of NAC and preoperative XRT may provide a RFS advantage in nonbilharzialsquamous cell bladder cancer. Those with clinically advanced disease continue to have a poor prognosis. However, OS does seem to have an improved prognosis compared to previous reports.