Many patients presenting with urinary incontinence will have neurological disease that impact their ability to maintain continence and empty their bladder. Underlying causes in children include congenital conditions such as spinal dysraphism (spina bifida), cerebral palsy and spinal cord injury. In adults, the most common neurological pathologies that affect the urinary tract include stroke, dementia, Parkinson’s disease, multiple sclerosis and spinal cord injury. These patients are generally complex with comorbidities and careful assessment with ongoing monitoring are hallmarks of best standard care. This chapter utilises common case examples to illustrate key principles in the management of neurogenic bladder dysfunction highlighting the importance of multidisciplinary input with tips and pearls from the various disciplines involved.