Overactive bladder (OAB) is a common condition with a signifi cant negative impact on the patients´ quality of life. OAB may be idiopathic or secondary to other conditions such as bladder outlet obstruction, neurological disease, or stress incontinence. Primary care physicians may safely diagnose this condition on the basis of history and physical examination with a minimum of widely available lab tests. Management with behavioral therapies and pharmacotherapy is generally successful. Many anticholinergic medications are available and have been shown to be effective. As the knowledge of differences in structure and mechanism of these agents may allow to attain improved therapeutic benefit or tolerability, it is reasonable to test more than one drug to achieve optimal results. For patients who fail behavioral and initial pharmacotherapy, or in case other complicating conditions are identified, referral to a urologist is indicated.