Patients with neurogenic detrusor overactivity (NDO) are a heterogeneous group with different underlying neurologic conditions associated with several urinary symptoms and systemic complications. The first-line, mainstay treatment of NDO are antimuscarinic drugs, but unfortunately they show a low adherence over the years. Thus, in recent years new effective and less invasive strategies were developed. Aim of the present paper is to present available data about these therapies. In particular, data on botulinum toxin A, which is already a recognized alternative to antimuscarinics, will be presented; the role of percutaneous tibial nerve stimulation and sacral neuromodulation in NDO will be discussed and will be provided some data about Mirabegron, a new drug available on market for overactive bladder patients.