Introduction: Radical Cystectomy (RC) and lymph node dissection is standard of care in MIBC. Bladder preservation techniques like trimodal therapy (TMT) has shown similar outcomes to RC with a complete response (CR) rate of 64-74%, 5 year overall survival (OS) rate of 50-70% along with 40-60% of bladder preservation. As bladder cancers show EGFR overexpression, anti-EGFR can be a potential treatment option in improving outcomes. Method: We retrospectively evaluated Nimotuzumab with concomitant chemoradiation (CRT) in Muscle invasive advanced bladder cancer (MIBC). Effectiveness and safety outcomes were analysed in these patients. Results: Sixteen patients with a transitional cell carcinoma and mean age of 63.8 (±4.4) were included Majority of the patients were male (87.5%) and 87.5% patients had tobacco addictions. All patients had an Objective Response Rate (ORR) (15 complete response and 1 partial response). With a median follow up duration of 61 months, median OS and Disease Free Survival (DFS) was not reached. DFS & OS rate of 1, 3, 5 and 7 year was 100% & 100%, 93.8% & 93.8%, 81.3% & 93.8% and 81.3% & 87.5%, respectively. Two patients had metastasis and one patient had recurrence. Two deaths were reported. Only two RC were performed subjecting an organ preservation rate of 87.5%. There were no grade 3/4 AEs recorded. Conclusion: Nimotuzumab with concomitant CRT improves outcomes with manageable toxicity and can play a potential role as bladder preservation treatment option.