Data on new surgical treatments for neurogenic lower urinary tract dysfunction (NLUTD) are reported. The aim of all these new approaches is to be less invasive than conventional surgery. Sacral neuromodulation (SNM) has been mainly used on incomplete spinal cord injured (SCI) subjects to treat their NLUTD. Loss of SNM efficacy during the follow-up is not always related to the worsening of the neurological status as in Multiple Sclerosis (MS) patients. Interestingly, positive effects on bowel and sexual function have also been documented. Current data support the use of laser for the treatment of urolithiasis. Few experiences, mainly in SCI males, are reported in literature regarding the use of laser for detrusor-sphincter-dyssynergia in suprasacral SCI and/or MS. The advantages of robotics in neuro-urological adults compared to open technique are still unclear. Experience is restricted to a few studies, mostly regarding reconstructive surgery like augmentation cystoplasty with or without catheterizable tube channels. Effectiveness of mesh sling repair is described in SCI patients affected by neurogenic stress urinary incontinence or mixed urinary incontinence because of coexisting NDO and/or low bladder compliance. Other minimally invasive procedures for N-SUI such as implanting adjustable periurethral devices have been reported even less in neuro-urological women (ACT) and men (proACT). Prospective and comparative studies that also evaluate the urodynamic outcomes of this specific population who are at risk for severe complications are needed to better assess efficacy as well as tailor treatments according to a patient’s specific NLUTD and neurological disease.