The international urological community refers to the syndrome of urinary frequency, urgency, and urge incontinence as Overactive Bladder (OAB), which has no clear etiology and is primarily characterized by detrusor instability, or detrusor overactivity, or other forms of urethrobladder dysfunction. It can also take the form of other forms of urethral-vesical dysfunction. In general, the number of patients seeking treatment for this condition is relatively small in practice. In my personal experience, there are fewer patients seeking treatment for OAB than for patients with bladder stones, acute and chronic cystitis, and most people probably think of it as a disease of the elderly. In recent years, there are few middle-aged people suffering from this condition. Data show that one out of every six adults in the United Kingdom has OAB, the proportion of adults in the United States with OAB is 16.6%, and there are not a few people with OAB in China. The diagnosis of OAB is not simple, because although OAB is an independent syndrome, it is often secondary to or associated with other diseases and can easily be overlooked in clinical practice. Based on this questionnaire and the OABSS scale, a patient with OAB can be diagnosed with a score of 2 or more on question 3 and a score of 3 or more on the overall OABSS. The OABSS quantitative criteria for the severity of OAB are: score ≤ 5, mild OAB 6 ≤ score ≤ 11, moderate OAB score ≥ 12, severe OAB. It should be noted that urinary urgency is the core symptom of OAB, and the absence of the complaint of urinary urgency does not confirm the diagnosis of OAB. In terms of the diagnosis and treatment, I think the seven-step approach is very useful. The first step is to rule out or diagnose frequent urination due to an abnormal increase in urine volume based on the medical history and 24-hour urination card. The second step is to rule out or diagnose neurogenic OAB based on the presence of neurological disease and injury. The third step is to rule out or diagnose OAB due to inflammatory irritation based on urine/prostate fluid examination. The fourth step is to rule out or diagnose OAB due to obstruction/foreign body irritation based on ultrasound/anal finger examination. The fifth step is to rule out or diagnose OAB due to small bladder capacity based on KUB+IVP and cystoscopy. Step 6 Exclude or diagnose OAB caused by psychiatric factors if there is anxiety or psychological disorders. Step 7 Diagnose idiopathic OAB if there is no obvious cause after all the tests. The general principle of treating OAB is to remove the primary cause and improve the symptoms. For OAB caused by abnormal increase in urine volume, appropriate control of water intake and control of the primary disease is the main concern; for secondary OAB such as urinary tract infection, prostatitis, prostatic hyperplasia, bladder tumor, stones, etc., the primary disease is actively treated, while anti-OAB drugs are used to relieve symptoms; for tuberculous small bladder and no narrowing of the urethra, bladder enlargement is feasible; for interstitial cystitis, the common treatment methods For interstitial cystitis, oral medications, bladder irrigation, bladder hydrodilation, sacral nerve electrical stimulation, and urinary diversion are commonly used; for neurogenic OAB and idiopathic OAB, bladder training and medications (tolterodine, etc.) are the preferred treatment, and bladder irrigation, sacral nerve electrical stimulation, and urinary diversion are the second-line treatments.