Background &amp; aims <p>Post-treatment anxiety and depression are prevalent but often underrecognized among bladder cancer patients. This systematic review and meta-analysis aimed to estimate the pooled prevalence of these symptoms and to evaluate the effectiveness of intensive nursing interventions.</p> Methods <p>A comprehensive search of PubMed, EMBASE, the Cochrane Library, and Web of Science was conducted through October 18, 2025. Eligible studies included those reporting the prevalence or severity of anxiety and/or depression in bladder cancer patients, as well as studies comparing intensive nursing interventions with routine care. Data were synthesized using Stata/MP version 14.0. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the I² statistic, and subgroup analyses were performed to explore potential sources of variability.</p> Results <p>Sixteen studies involving 1,791 patients were included. The pooled prevalence of anxiety was 25.3% (95% CI: 22.2–28.6%) and that of depression was 29.4% (95% CI: 23.3–35.9%). Higher prevalence rates were observed in non-Western populations and among patients receiving multimodal treatment. Compared with routine care, intensive nursing interventions were associated with significant reductions in anxiety (SMD = –4.52; 95% CI: –6.07 to –2.96) and depression (SMD = –4.51; 95% CI: –5.96 to –3.07) (both <i>P</i> &lt; 0.001). These findings remained robust in sensitivity analyses despite substantial heterogeneity.</p> Conclusion <p>Anxiety and depression are common among bladder cancer survivors. Intensive nursing interventions are associated with meaningful improvements in psychological outcomes and may be considered for integration into post-treatment supportive care.</p> Trial registration <p>PROSPERO registration number: CRD42024590858.</p>