OBJECTIVE: A significant portion of the population endures economic, physical, and emotional burdens from overactive bladder (OAB). OAB, with and without incontinence, causes strong, sudden, and unpredictable urges to urinate. People with OAB may be at greater risk for urinary tract infections (UTIs), falls and fractures, and increased medical visits, but to date, the extent to which consequent treatment costs are associated with OAB is unknown. METHODS: The National Overactive BLadder Evaluation (NOBLE) Program included a US survey of 5204 English-speaking adults over 18 years to estimate the prevalence of OAB. All OAB cases and age- and gender-matched controls were sent a follow-up questionnaire to assess the occurrence of UTIs, falls, and medical visits in the past year. A total of 397 (46%) patients and 522 (57%) controls returned the questionnaires. The non-response rate of patients and controls did not differ with age, gender, educational status, diabetes, congestive heart failure, or self-rated health status. UTIs and physician visits were analysed using multivariate regression models, controlling for age, gender, race, education, marital status, births, self-reported health status, and presence of diabetes and congestive heart failure. RESULTS: People with OAB averaged 20% more physician visits (P < .001), had 57% more UTIs in the last year (P < .001), and had over twice the odds of being injured in a fall than people without OAB (OR=2.26; 95% CI 1.46, 3.51; P < .001). Sensitivity analyses (removing 5% of the outliers as identified with Cook’s distance) indicated that the effects were robust. Cost estimates associated with OAB in the year 2000 were approximately $1.37 billion and $273 million US dollars for UTIs and falls/broken bones, respectively. CONCLUSIONS: OAB increases the risk for UTIs and fall injuries and results in more physician visits. OAB-related costs were over $1.6 billion US dollars in 2000. Effective treatment would likely reduce these costs.