Hypothesis: bladder pain syndrome (BPS) presents by both urological and gynecological symptoms. The gynecological symptoms include chronic persistent pelvic pain, dyspareunia and decreased libido on the other hand urological symptoms include wide variety of symptoms as bladder discomfort, dysuria, frequency, and urgency. Although, the definition and diagnostic criteria for the condition was established, the pathogenesis, etiology and histologic findings of BPS are still not fully understood and diagnosis is made by exclusion. Review of published data including both gynecological and urological articles focusing on the updates in the diagnostic tests, pathology and the recent therapies. The searched words were bladder pain syndrome, interstitial cystitis and painful bladder. The free full text article found after our search were 454 articles after exclusion of deficient article not covering the whole subject, 91 articles were enough for this work to be completed. From this review, Bladder pain syndrome is still unclear disease lacking curative therapy up till now and patients are still suffering and the mixed complex symptoms put further challenge on both urologists and gynecologists to solve the problem.