In this review, we describe the history and basic science behind intermittent neuromodulation, specifically of the tibial nerve and its neuroanatomic suitability for this approach, as well as the logistics, efficacy, and advantages of peripheral tibial nerve stimulation (PTNS) in both idiopathic and neurogenic overactive bladder (OAB) populations. We also discuss the less commonly used sacral, pudendal, and genital nerves as a means of intermittent neuromodulation for the management of OAB. Intermittent neuromodulation in the form of PTNS is approved as a third-line treatment of OAB, which affects upwards of 16% of the population of the USA. Several studies and clinical trials have demonstrated the effectiveness of PTNS in treating OAB, with the benefit of decreased cost and invasiveness compared to chronic, implantable neurostimulators. This has been explored in various patient populations including patients with idiopathic and neurogenic detrusor overactivity.