The function of the lower urinary tract, to store and periodically eliminate urine, is very simple but its neuronal control is complex and reflects the high prevalence of dysfunction in patients with neurological diseases. The aims of the neuro-urological management are the preservation of upper urinary tract function, enhancing of quality of life, control of urinary tract infection, and maintenance of a low-pressure bladder that is both continent and capable of emptying completely. An appropriate neuro-urological work-up is essential to achieve these goals including (as appropriate) medical history, validated questionnaires, bladder diary, physical examination, urethro-cystoscopy with bladder washing cytology, renal function assessment, and non-invasive / invasive urodynamics. In the neuro-urological patient, meticulous lower urinary tract function assessment is crucial. It is the prerequisite for clinical decision making and for tailoring treatment to the individual patient.