The combination of; gemcitabine and docetaxel (Gem/Doce) as intravesical chemotherapy has been considered as a possible alternative to BCG installations when treating patients with non-muscle invasive bladder cancer (NIMBC), the Gem/Doce combination gained popularity in 2021 due to worldwide BCG shortage. Lately, several research articles assessed the efficacy of this therapy in different settings.; We seek to determine the efficacy of the treatment in patients with low and intermediate risk disease using 2 different protocols using Gem/Doce induction only versus; Gem/Doce induction with maintenance. Our single institution prospectively maintained database identified consecutive patients who were diagnosed with NIMBC during 2020-2023, included were low risk and intermediate BCG naïve patients with non-muscle invasive bladder cancer who received Gem/Doce induction and maintenance courses. Patients were stratified according to the treatment protocol. Bladder cancer risk-group stratification was performed using AUA guidelines 2016. Baseline characteristics, pathology, cystoscopy, and cytology reports were collected from electronic medical charts. Study findings were reported using descriptive statistics. Kaplan-Mayer survival analysis was performed to detect Recurrence-free survival (RFS). A p-value of <0.05 was considered statistically significant. R programming language version 4.3 was used for all statistical analyses. A total of 49 patients were included in the study, the median age was 74 (IQR 64-78).; Thirteen patients (27%) were females. The median follow-up time was 9 months (IQR 4-15), risk-group stratification yielded 5 patients with low-risk disease (10%) and 44 patients with Intermediate-risk disease (90%). Four patients (8%) had prior BCG exposure more than 2 years before initiation of treatment. Overall, 21 patients (43%) had recurrences at any point. One patient at the induction with maintenance arm developed a metastatic disease and died as a consequence. RFS at 3, 6, and 12 months for the Gem/Doce induction only was 97%,70%, and 51% and for Gem/Doce induction + maintenance 100%,;94%,;and 94%. Gem/Doce Induction with maintenance arm had better RFS at median follow-up time than induction only arm (Figure 1.). Baseline characteristics stratified according to treatment arm are presented in Table 1. The use of Gem/Doce induction with maintenance resulted in superior recurrence free survival than induction only in patients with low and intermediate risk non-muscle invasive bladder cancer. However, further prospective trials with bigger cohorts and longer follow-up time are necessary to validate our results.