Purpose of Review <p>This manuscript aims to provide an overview of the pathophysiology of voiding dysfunction, management goals, and treatment options for individuals with spina bifida in order to better assist providers caring for these patients and their families.</p> Recent Findings <p>Recent studies have demonstrated efficacy and safety of beta-3 agonists and onabotulinum toxin A as noninvasive options for management of neurogenic lower urinary tract dysfunction. Studies focusing on patient reported outcomes and health-related quality of life have raised greater awareness of patient goals and socio-environmental factors in the counseling of different treatment options.</p> Summary <p>This review highlights the latest research on the management of voiding dysfunction in patients living with spina bifida. Better understanding of pathophysiology and new developments in non-invasive treatment options have substantially improved long-term durability and outlook for these patients. Future research should aim to identify patient and family goals to better manage expectations and quality of life for this lifelong condition.</p>