Physical therapists are musculoskeletal specialists that are uniquely qualified to assist in the assessment and development of muscle strength and coordination, as well as supporting the progression of sensory awareness required for continence. Given the anatomical differences and early surgical intervention with bladder exstrophy-epispadias complex (BEEC), it is essential for early physical therapy evaluations and interventions to be part of the patient’s care plan. The International Classification of Functioning, Disability, and Health (ICF) model can assist in the identification of impairments at the body structure, activities, and participation level that require intervention or accommodation to optimize quality of life and toileting success throughout the BEEC journey.