Purpose of Review <p>We examined the added value of video urodynamics (VUDS) and the circumstances under which it may be favored over conventional urodynamics (CUDS) for assessing neurogenic lower urinary tract dysfunction (NLUTD).</p> Recent Findings <p>VUDS is particularly valuable in identifying vesicoureteral reflux (VUR), detrusor-sphincter dyssynergia (DSD), bladder outlet obstruction (BOO), and bladder wall abnormalities. The findings may not be apparent on CUDS and are essential in tailoring interventions, especially in patients with spinal cord injury (SCI) or spinal dysraphism (SD). VUDS also informs surgical planning and is indispensable when clinical deterioration occurs despite normal CUDS findings. Fluoroscopic radiation exposure concerns may be mitigated by low-dose radiation protocols.</p> Summary <p>While not universally required for all patients with NLUTD, VUDS is valuable in specific high-risk scenarios or when standard UDS findings are incongruent with clinical presentation. When available and used judiciously, VUDS offers a more complete understanding of both function and form, allowing for tailoring of therapy with greater precision and confidence.</p>