Purpose of Review: Urinary incontinence is highly prevalent and very costly. Proper detection and evaluation of urinary incontinence can facilitate appropriate treatment options for older women. Our goal is to discuss first-line, nonsurgical management of urinary incontinence in older women. We include behavioral, lifestyle, and pharmacologic management options. Recent Findings: Behavioral treatment options represent first-line treatments and have efficacy data for all types of urinary incontinence. Behavioral treatments include pelvic floor muscle exercises, strategies for controlling stress and urgency symptoms, bladder training, and lifestyle interventions. Pharmacologic treatment options are available for urgency and mixed urinary incontinence which include antimuscarinics and β-3 adrenoreceptor agonists. Emerging data exists for vaginal estrogen use and pharmacologic treatments among frail, older women. Pharmacologic therapies have specific considerations when using in frail or cognitively impaired women who are more susceptible to adverse drug events. Summary: Efficacious management options exist for older women with urinary incontinence. Given overall poor adherence rates to incontinence treatments among all women, older women should be monitored closely for response to management options, and referral considered when indicated.