Although surgery has a limited role in the management of metastatic urothelial carcinoma patients, it can be envisaged in association with chemotherapy. In highly symptomatic patients and for complete response patients, cystectomy can be part of a multimodal approach. Metastasis resection can also be proposed in association with chemotherapy in case of complete response. In case of non responsive metastasis, metastasectomy can also de discussed in order to improve quality of life.