Urinary incontinence, which may lead serious psychological and social complications such as depression, anxiety, embarrassment, and social isolation is an important and common health care problem affecting the elderly population. Successful management of urinary incontinence in this population requires an understanding of the anatomical and physiological changes due to the aging process. Different therapeutic modalities often lead to an appreciable improvement of the symptoms, and sometimes a cure even in old patients. Pharmacologic therapy may be an option, however when selecting a drug therapy for the management of an elderly patient, in addition to considering evidence of clinical efficacy and tolerability, issues of safety specific to this age group should be borne in mind. Anticholinergic agents are important in the treatment of urinary incontinence. Each has demonstrated efficacy for the treatment however, their pharmaco-kinetic and adverse event profiles differ somewhat due to structural differences, muscarinic receptor subtype selectivities, and organ selectivities.