OBJECTIVES:  Falls are an important cause of morbidity and mortality in older adults. Symptoms associated with overactive bladder (OAB) increase the risk of falls. The study objective was to synthesize estimates of the risk of falls among those with OAB versus those without. METHODS:  A systematic search was implemented in Medline, EMBASE, CINAHL, and Scopus, using terms for OAB, its symptoms, and falls. Two reviewers independently screened all abstracts and full-texts, and performed double data extraction on eligible articles. Data were summarized by the percentage with OAB experiencing falls, the unadjusted attributable risk of falls associated with OAB, and adjusted odds ratios for falls associated with OAB. Estimates were stratified according to whether falls were ascertained prospectively, according to OAB-related symptom, and according to treatment status, where available. RESULTS:  The search identified 45 articles. Among samples with OAB where falls were assessed prospectively, the percentage with falls ranged from 25.3% (mean age, 69 years) to 50% (mean age, 81 years; all females) over one year; the attributable risk of OAB related falls was 9.2% and 3.7%, respectively. Among samples with OAB where falls were assessed retrospectively, the percentage experiencing falls ranged from 23.0% (mean age, 68 years) over one month to 45.1% (mean age, 79 years; all females) over one year; the attributable risks of falls due to OAB was 7.7% and 15.5%, respectively. The adjusted odds of falling over one year ranged from 1.7 (1.6-1.8) to 2.3 (1.5-3.5). Estimates were higher from studies with more females and greater mean age. Evidence on the impact of OAB treatment on falls risk are limited. CONCLUSIONS:  OAB and its symptoms are important risk factors for falls, even after adjustment for other known risk factors. Designing studies with prospective ascertainment and longer follow-up periods is important to accurately capture events of interest.