Bladder cancer (BC) is the fifth most common cancer by incidence in Armenia, with 500–550 new cases diagnosed every year. For this retrospective hospital-based study, we collected data during the period 01 January 2010–01 January 2023 from three main oncology centres in Armenia: ‘Yeolyan Hematology and Oncology Center’, ‘Mikaelyan Institute of Surgery’ and “Muratsan” Hospital Complex of Yerevan State Medical University. Statistical analysis was conducted on 01 November 2023. Eighty-seven patients with BC treated during the mentioned period in these three hospitals were included in the final analysis. The male-to-female ratio was 8.6:1. Median age at diagnosis was 65 years. About 5.7% of patients had stage I, 17.2% stage II, 47.1% stage III, 25.3% stage IV BC and for 4.6% of patients, the stage was unknown. Among stage IV patients, the most common metastasis sites were lungs (36.4%), followed by non-regional lymph nodes (31.8%). Median overall survival (mOS) was 31 months for the entire cohort. An mOS was 62 months for stage II, 40 months for stage III and 14 months for stage IV patients. While overall survival for stages II–III, BC was higher than for the metastatic stage; this difference was not statistically significant (40 versus 14 months; p = 0.11). Around 61% of patients received first-line chemotherapy with cisplatin and 33.3% with carboplatin. In people with stage II–III BC, an mOS was significantly better for those treated with cisplatin-containing regimens, compared with those treated with carboplatin-containing regimens (40 versus 16 months; p = 0.021), while in stage IV, this difference was not statistically significant (30 versus 14 months; p = 0.269). In conclusion, this retrospective study with a relatively small number of patients has shown that the survival of patients with metastatic BC in Armenia is poor, with an mOS just surpassing 1 year. We believe that the implementation of newer drugs, like immunotherapy and antibody-drug conjugates, may improve outcomes.