Urinary incontinence is a common problem among older women and men, has a significant negative impact on quality of life, and may be costly to treat. Older women experience higher rates of urinary incontinence than older men. The causes and types of urinary incontinence also differ among older women and men. Often, older adults are reluctant to seek treatment, and healthcare providers should inquire about symptoms. Detection of urinary incontinence and determination of severity and related symptoms is important for evaluation and treatment. Urinary incontinence can be evaluated and initially treated by primary-care providers. Evaluation for urinary incontinence involves a focused history, physical examination, a urinalysis, and measurement of postvoid residual volume, if indicated. Office-based treatments include behavioral approaches and medications. Older adults may also consider surgical options and devices to improve urinary incontinence. Older adults with cognitive impairment and incontinence require diagnostic and treatment modifications, but may respond well to treatment. © 2011 Mount Sinai School of Medicine.