Tethered cord syndrome is a complication of spinal dysraphism. The tethering of the cord does not permit the normal cranial migration of the conus within the vertebral canal and this results in neural dysfunction due to a traction neuropathy. Although this condition commonly presents in childhood, less severe degrees of tethering may remain asymptomatic until adult life. The clinical features, imaging and management of 5 adults with this condition are reviewed. Both urological and neurosurgical intervention are aimed at preservation of function as, unlike the sensorimotor deficit that commonly complicates this condition, improvement in bladder function is uncommon following cord release.