Overactive bladder is an important lower urinary tract syndrome that negatively affects the quality of life of millions of people worldwide. Both sexes and all age groups may be affected; therefore many specialists, including urologists, gynaecologists, geriatricians, paediatricians, physiotherapists and continence advisors, are involved in the management of patients with overactive bladder.There is ongoing research, both basic science and clinical trials, to establish the cause of overactive bladder and to determine the best method of managing patients who suffer from this syndrome. New theories and modified definitions of overactive bladder have been proposed, structured evidence-based management guidelines have been established, more prevalence studies have been conducted and new treatment strategies have emerged.Overactive bladder is now recognized as a chronic debilitating condition that costs millions of dollars. With an ageing population these costs will increase, and it is necessary that health systems around the world recognize this. Further research into the basic science of the condition is required to identify the true cause of overactive bladder, allowing new targeted treatments to be established.