Management of the female patient with neurogenic bladder requires special considerations that are not seen with many male neurogenic bladder patients. Because of the unique challenges that certain women present, a disproportionate number of women end up with an indwelling catheter or continuously leak urine into a diaper. Other options for bladder management include intermittent catheterization and reconstruction, which, when used appropriately, can lead to significant improvements in urinary continence, quality of life, and patient independence. This article reviews the various options available today as well as several potential therapies that may be available in the future.