Although patients benefit from surgical transurethral resection of bladder cancers, some niduses are missed or incompletely resected, and small malignant lesions may recur. Intravesical chemotherapy and immunotherapy are universally accepted as adjuvant treatments after surgery to avoid recurrence and progression. However, these treatments still have limitations, including an insufficient retention period, inefficient permeability of chemotherapeutic agents, and dilution of the agents by urine. Nanostructure-based smart therapeutic platforms can be tailored to be responsive to internal or external stimuli to ameliorate this situation. This unparalleled capability empowers the precise aggregation of stimulus–responsive nanocarriers in the target regions, namely, the tumors, and subsequent release of the anticancer materials. This review summarizes the current nanostructure-based therapeutic platforms, especially stimulus–responsive nanocarriers, and highlights their benefits and limitations in bladder cancer therapy. Novel innovations in nanotechnology have undoubtedly arrived at a new height and have become useful for practical applications. Nanotechnology will positively promote the development of anticancer agents not only for bladder cancer but also for other solid tumors.