Background <p>Lower urinary tract dysfunction (LUTD) is a potential late effect in childhood cancer survivors, often overlooked in survivorship care. Neurotoxic chemotherapy, pelvic tumors, and radiation exposure may contribute to its development.</p> Objectives <p>To determine the prevalence and severity of LUTD in childhood cancer survivors and identify associated risk factors.</p> Methods <p>A prospective observational study was conducted over six months among 92 childhood cancer survivors aged ≥ 5&#xa0;years to 10&#xa0;years. Participants were screened using the LUTD Scoring System (DVSS). A score ≥ 9 in males and ≥ 6 in females was considered diagnostic of LUTD. Clinical and treatment-related variables were extracted from medical records and analyzed for associations. Uroflowmetry and ultrasonography were performed in children with abnormal DVSS to further assess voiding pattern and bladder parameters.</p> Results <p>LUTD was identified in 20 of 92 participants (21.7%), with a higher prevalence in females (31.6%) compared to males (14.8%), though this difference was not statistically significant (<i>p</i> = 0.073). Significant associations were observed with pelvic tumors (<i>p</i> = 0.002; Φ = 0.394), pelvic irradiation (<i>p</i> &lt; 0.001; Φ = 0.455), Vinca alkaloid use (<i>p</i> = 0.035; Φ = 0.307), and high cumulative alkylating agent dose (&gt; 8000&#xa0;mg/m²) (<i>p</i> = 0.017; Φ = 0.267). Uroflowmetry confirmed abnormal voiding patterns in 95% of DVSS-positive patients. Most cases were managed conservatively with bladder training, while a subset required anticholinergics or laxatives.</p> Conclusion <p>LUTD is prevalent among childhood cancer survivors, particularly those exposed to Vinka alkaloids and pelvic-directed therapies. Routine LUTD screening using DVSS should be integrated into long-term follow-up protocols for early detection and intervention.</p>