Purpose of Review <p>The prevalence of male lower urinary tract symptoms (LUTS) is increasing, and its causes are varied. The role of video-urodynamics (VUDS) in diagnosing and managing male LUTS is still evolving. This review evaluates the most recent evidence on the application of VUDS in male LUTS and highlights clinical conditions where it is recommended.</p> Recent Findings <p>VUDS has shown promise for men under 60, who are more likely to suffer from primary bladder neck obstruction (PBNO) and dysfunctional voiding (DV). The use of VUDS is also indicated in men with elevated postvoid residual (PVR) volumes due to the risk of vesico-ureteral reflux (VUR) and bladder diverticulae. Additionally, patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) unresponsive to conventional treatment may benefit from VUDS, as many have underlying found that there is a high proportion of these patients who have underlying lower urinary tract dysfunction (LUTD), including PBNO, DV, or underactive bladder (UAB). VUDS may also be useful for patients with post-prostatectomy incontinence seeking surgical management, as VUDS can identify urethral strictures and subtle leaks confined to the bulbar urethra. VUDS is also useful for men with a history of pelvic surgery or radiotherapy, as it can identify anatomical changes or compliance issues that increase the risk of VUR and damage to the upper urinary tract, including hydronephrosis and renail failure.</p> Summary <p>While literature remains limited, recent studies support the selective use of VUDS in younger males and those with specific risk factors such as high PVR, CP/CPPS, PPI, or a history of pelvic surgery. VUDS offers additional diagnostic benefits that standard urodynamics may not capture.</p>