Urothelial cells in the urinary bladder express neural properties including: (1) release of neurotransmitters and neurotrophic factors, (2) expression of neurotransmitter receptors and ion channels, and (3) sensitivity to mechanical and chemical stimuli. These properties have focused attention on the possible contribution of the urothelium to the storage and emptying functions of the bladder. In addition chemicals released from urothelial cells can affect the excitability of adjacent afferent nerves and this interaction can be affected by pathological conditions. This raises the possibility that abnormal urothelial–afferent interactions may contribute to bladder dysfunctions and therefore be a target for drug therapy.