Introduction and hypothesis: The objective of this study was to examine the effects of drug therapy alone and combined with behavioral therapy on urgency and 24-voiding frequency in women with urge-predominant incontinence and to identify predictors of change. Methods: A planned analysis of data from a multi-site, randomized, controlled trial (N=307). Bladder diaries were used to document voids, incontinence, and urgency severity. Results: Urgency scores decreased significantly within both treatment groups, but changes did not differ between groups (p=0.30). Improvement in urgency was associated with greater baseline urgency (p<0.0001) and black ethnicity (p=0.03). Voiding frequency increased with drug alone and decreased slightly with combined therapy (p=0.009), and improvement was associated with combined treatment (p<0.0001), higher baseline frequency (p<0.0001), and lower baseline incontinence episode frequency (p=0.001). Conclusions: Although combined drug and behavioral therapy does not appear to improve urgency more than drug alone, it resulted in better outcomes on voiding frequency. © 2010 The International Urogynecological Association.