The purpose of the review is to outline current guidelines for evaluation and treatment of nocturia. Nocturnal polyuria currently has no consensus definition; it is most often reported as either nocturnal urine production (NUP) >90 mL/h or nocturnal polyuria index (NPi) >.33. Clinical trials for oral dispersible desmopressin (melt) demonstrate utility as a pharmacological treatment of refractory nocturnal polyuria, but also introduce risk of hyponatremia; it currently is unapproved in the USA. Nocturia is a prevalent condition that shows an increased risk with age and is associated with increased mortality and decreased quality of life. Nocturia should be managed by first classifying the cause as either global polyuria, nocturnal polyuria, diminished bladder capacity, sleep disorder, or mixed etiology through bladder diaries, and then further specifying the etiology. Effective nocturia treatment is dependent on its cause and should be determined on a case-by-case basis. Treatment recommendations include addressing comorbidities, behavioral therapy, pharmacological therapy, and surgical intervention.