Lower urinary tract symptoms and disorders are commonly encountered by nephrologists because they often coexist with or may contribute to various kidney diseases. Thus, an understanding of lower urinary tract disorders and knowing when consultation with urology is warranted are essential to nephrology practice. In this review, we examine lower urinary tract physiology and outline a practical, clinically oriented approach to the initial work-up for lower urinary tract symptoms, including history, physical examination, and office-based testing.