Overactive bladder (OAB) and urinary tract infection (UTI) can both cause frequent, urgent urination, but they differ in key ways that affect treatment. OAB tends to be chronic and trigger-based (caffeine, alcohol, stress), with urgency, frequency, nocturia, and possible urge leakage—but usually without burning, fever, or foul-smelling/cloudy urine. UTIs often start suddenly and bring pain or burning with urination, pelvic or back discomfort, cloudy or strong-smelling urine, possible blood, and sometimes fever or confusion in older adults; a quick urinalysis and culture can confirm. This article clarifies the clues to tell them apart, what to track before a visit, and the right treatments—behavioral strategies and medications for OAB versus short antibiotic courses and hydration for UTIs—plus red flags needing prompt care (fever, flank pain, vomiting, pregnancy, or no improvement in 48 hours). The goal is to help patients and caregivers choose the right next step and avoid unnecessary antibiotics or ongoing symptoms.