Spina bifida is a serious health care problem with life long disabilities and it is also the most common cause of neuropathic bladder dysfunction in children. Upon recent developments in medical practice, the life expectancy of children with spina bifida has increased. Urological management is one of the main issues in the quality of life and health of these patients. With the understanding of the natural course of the disease, we can set standards in the treatment of the urological complications of the disease. This report summarizes the contemporary urological approach to the children with spina bifida and the problems in the natural course of the disease.