SummaryAimsThe aim of this study was to investigate the quality and timing of the diagnosis and treatment of nocturia in real‐life practice in European and US‐American patients to obtain better insights into the management of nocturia in different Western healthcare systems.MethodsData were drawn from the “LUTS Disease Specific Programme,” a real‐life survey of physicians and patients in France, Germany, Spain, UK and the USA. Physicians completed a patient record form for lower urinary tract symptoms (LUTS) patients. Patients filled out a self‐completion form, indicating – among other items – information on the mean number of day‐ and night‐time voids during the last 7 days, and questions on the management of LUTS in daily practice.ResultsIn total, 8659 patients were analysed. The majority of patients initially consulted a physician because of worsening of LUTS frequency (43%–58%) or severity (44%–55%). Only 37% of all LUTS diagnoses, regardless of the appearance or severity of nocturia, were based on bladder diaries. Patients took approximately 1 year to consult a medical professional following the onset of LUTS. At the initial visit, most patients received advice on behavioural strategies. Regardless the type of LUTS and physician, 59% of men received α‐blockers and 76% of women antimuscarinics.ConclusionsData show that patients with nocturia and LUTS accept their symptoms for a considerable period before they seek help or ultimately receive treatment. They may therefore be enduring significant negative impact on their quality‐of‐life which could be avoided. Physicians rarely use bladder diaries and primarily use antimuscarinics (women) or α‐blockers (men). Improved awareness of nocturia among patients and physicians could improve the management of nocturia.