The overactive bladder syndrome and the neurogenic detrusor overactivity figure among the most impacting voiding dysfunctions with a high global prevalence and negative impacts on quality of life. Despite such urinary disorders being easily diagnosed, often based exclusively on clinical data, a large number of people complaining of urgency, frequency, nocturia and, in many cases, urinary incontinence, have their urinary condition neglected. The first line treatment with oral anticholinergics presents a high rate of dropouts over a few months of use, due absence of success or the adverse events frequently observed with this therapy. Intradetrusor botulinum toxin injection was initially used for patients with spinal cord injury and multiple sclerosis, nearly 15 years ago. Its successful results led to the injections in detrusor of botulinum toxin also in refractory idiopathic overactive bladder.