Once thought to be rare, interstitial cystitis (IC) is now believed to have a markedly higher prevalence. This potentially devastating disease is also known as painful bladder syndrome (PBS) and can significantly impact quality of life. It is diagnosed by its symptoms, as there are no proven pathological findings. Unfortunately, the symptoms of IC/PBS overlap those of other common disease states such as overactive bladder, endometriosis, urinary tract infection, and prostatitis, which complicates the differential diagnosis. Understanding the presenting symptoms of urinary frequency, urinary urgency, and pelvic pain in the presence of otherwise normal findings can enhance primary care providers' ability to appropriately identify the disease. Early identification may allow initiation of therapy or referral before the disease becomes refractory to standard treatment, which typically includes behavioral therapy and possibly multimodal drug therapy.