Overactive bladder (OAB) is a condition that affects millions of women in the United States (US). Although the etiology is largely unknown, risk factors include Caucasian race, insulin-dependent diabetes mellitus, and history of depression. Patients present with urgency with or without urinary incontinence and often have urinary frequency and nocturia. Most patients can be evaluated in the office setting utilizing simple testing. Current treatments consist of behavioral/lifestyle modification, usually in combination with antimuscarinic drug therapy. Improvements in the adverse effect profiles of antimuscarinic drugs have positively impacted quality of life. When appropriately evaluated, most patients presenting to primary care providers can be effectively treated.