Objective This study explored nucleolar and spindle associated protein 1 (NUSAP1) in the bladder urothelium cancer (Bladder urothelial carcinoma, BUC) tissue expression and its relationship with clinicopathological parameters and lymph node metastasis. Methods 103 cases of pathological specimens of radical resection of bladder cancer were selected from January 1, 2017 to August 31, 2020. 50 normal bladder tissues were selected. The expression of NUSAP1 in bladder cancer tissues was detected by immunohistochemistry. The clinical pathological parameters of NUSAP1 expression in bladder cancer patients were analyzed. And the relationship between lymph node metastasis. Results The positive expression rate of NUSAP1 was（88/103）85.4% and（11/50）22.0% in BUC tissues and normal bladder tissues, respectively (P＜0.05). The expression level of NUSAP1 was significantly correlated with tumor diameter, tumor number, pathological grade, lymph node metastasis and clinical stage in BUC patients (P＜0.05). Lymph node metastasis was significantly associated with tumor diameter, number of tumors, pathological grade, clinical stage, and NUSAP1 expression level (P＜0.05). Logistic multivariate regression analysis showed that only NUSAP1 expression level was an independent factor affecting BUC lymph node metastasis（OR:1.951, 95%CI:1.094-3.477, P＝0.023）. Conclusion NUSAP1 is highly expressed in BUC tissues and is an independent predictor of lymph node metastasis.