Objective To observe the clinical effect of gemcitabine assisted plasmakinetic resection of bladder tumor (PKRBT) in the treatment of non-muscle invasive bladder cancer (NMIBC).Methods This study is a prospective study that selected 90 NMIBC patients admitted between January 2020 and May 2022 as the study subjects. They were randomly divided into a surgical group (45 cases) and a combination group (45 cases) using computer randomization. All patients underwent PKRBT, while the combination group received adjuvant treatment with intraoperative injection of gemcitabine. All patients underwent a one-year follow-up to compare the short-term efficacy and prognosis of the two groups of patients.Results Under different treatment regimens, the YKL-40 and DKK-1 levels in the combination group were 50.25±10.36 ng/mL and 6.62±1.45 ng/mL, lower than the surgical group (55.38±10.72 ng/mL and 8.65±2.82 ng/mL). The CEA, AFP, and sICAM1 of the combination group after treatment were 255.65±20.33 ng/mL and 345.25±30.36 μg/L, 411.24±40.62 μg/L, lower than the surgical group (270.33±20.41 ng/mL, 368.72±30.61 μg/L, 441.36±40.27 μg/L). The ORR and DCR of the combination group after treatment were 77.78% (35/45) and 88.89% (40/45), higher than those of the surgical group [55.56% (25/45) and 62.22% (28/45)]. The PFS and OS of the combination group within one year were 10.25±2.21 months and 11.36±2.41 months, higher than those of the surgical group (8.14±1.65 months and 9.29±1.33 months), with a relapse rate of 17.78% (8/45) lower than 33.33% (15/45) of the surgical group. The scores of physical function, psychological function, social function, common symptoms, and side effects in the QLICP-BL scale of the combination group were 35.25±5.11 points, 40.32±5.29 points, 35.26±5.22 points, and 30.23±5.18 points, higher than those in the surgical group (32.11±5.46 points, 37.45±5.25 points, 32.28±5.21 points, and 27.44±5.13 points) (P<0.05).Conclusion Multi point injection of gemcitabine through the bladder mucosa during PKRBT in NMIBC patients can effectively improve their short-term efficacy, improve their short-term prognosis, reduce the risk of disease recurrence, and improve their quality of life.