OBJECTIVE To assess the relationship between symptom severity and patient perceptions in patients with overactive bladder (OAB), as estimated by OAB Symptom Score (OABSS) and patient-reported outcome measures, respectively. PATIENTS AND METHODS Post-hoc analyses were conducted on the existing data from patients with OAB. In addition to the OABSS, patients completed three patient-reported outcome measures, the OAB questionnaire (OAB-q), Patient Perception of Bladder Condition (PPBC) and Medical Outcomes Study Short-Form 36 (SF-36). Relationships of the OABSS were assessed through correlations with the OAB-q, PPBC and SF-36; all analyses were exploratory. RESULTS In all, 194 participants were analysed; the OABSS correlated relatively closely with the PPBC and OAB-q subscales of health-related quality of life (r = 0.36-0.57). There was a particularly good correlation with the OAB-q symptom bother (r = 0.73). However, the OABSS correlated somewhat less with the SF-36 subscales (r = 0.16-0.27). There were fairly close correlations between the OABSS and the OAB-q items; for daytime frequency with 'frequency of urination during daytime hours' (r = 0.44); night-time frequency with 'night-time urination' (r = 0.44), 'waking up at night because you had to urinate' (r = 0.51) and 'awakening from sleep' (r = 0.44); urgency with 'a sudden urge to urinate with little or no warning' (r = 0.65) and 'an uncontrollable urge to urinate' (r = 0.69), urgency incontinence with 'accidental loss of small amounts of urine' (r = 0.74) and 'urine loss associated with a strong desire to urinate' (r = 0.79). All the items except 'awakening from sleep' belonged to the OAB-q symptom bother domain. CONCLUSIONS It is possible to roughly but sufficiently infer patient perceptions of bladder condition and symptom bother by measuring symptom severity, as estimated by the OABSS.