Recognition of enuresis, a vexing identified clinical symptom predates modern civilization, and harsh physical procedures were used as the prevalent treatment methods since the 18th and 19th centuries. The account of treatment interventions is replete with documented controversy. Today the conflicting views and approaches center on the work, research and writings of therapists classified as: learning theorists, behaviorists, psychopharmacologists, and psychodynamic, analytically oriented clinicians. The manuscript reviews theories of etiology of Primary Nocturnal Enuresis (PNE), the evaluation process, and the myriad of treatment procedures currently utilized. The reader is offered a review of the history of treatment of this symptom and an overview of the competing current paradigms. A detailed case presentation is offered to demonstrate the efficacy of psychotherapy, i.e., analytically oriented play therapy commonly utilized as the treatment of choice by psychoanalysts, clinical psychologists and clinical social workers.