The overactive bladder is the commonest underlying bladder disorder causing urinary incontinence in elderly people. Management of the condition relies upon a holistic assessment of the problem, lifestyle adjustment, behavioural management and drug therapy. The majority of currently available drugs rely on their anti-muscarinic properties for efficacy. Both behavioural techniques and drug therapy are effective in treatment of the elderly and each modality has a particular role to play in successful treatment and maintenance of this condition.