Abstract Up to 10% of school-age children suffer from recurrent urinary tract infections (UTIs) and/or urinary incontinence. Lower urinary tract problems are, together with asthma, the most important chronic disease of the pediatric age group. Diagnosis must discriminate among those children with functional voiding problems, those with neuropathic bladders, and those with anatomic anomalies who may need surgery. In boys with overactive bladder (OAB) and incontinence, urethral obstruction must be evaluated as the possible cause. Functional incontinence with lower urinary tract symptoms (LUTS) is very common in girls and can be accompanied by UTI. In girls with dysfunctional voiding or underactive bladder, other anomalies need to be excluded because, for many of these girls, LUTS can be a chronic condition that requires lifelong attention to voiding behavior.