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About 115 years ago, the first diagnosis of interstitial cystitis (IC) was offered as a reason to explain the pain related to scarring and inflammation in the bladder. Later, Hunner described the pathognomonic ulcer that bears his name, which is only found in about 5% to 10% of patients with IC. Today, IC is considered a controversial diagnosis. There are still a significant number of clinicians that do not believe in the diagnosis. Some people consider it to be only a diagnosis of exclusion – after every other bladder condition has been ruled out. However, population studies have demonstrated that there is a huge number of patients (mainly female) that fulfill the NIH and/or other diagnostic criteria and deserve the treatment for IC. Frequency, urgency and pain (pelvic and/or voiding) with negative urinary cultures should be considered IC and treated as such. Dyspareunia is one of the commonest complaints of the IC sufferer. The physical, sexual and emotional impact of delayed or misdiagnois of this condition can be devastating or even suicide-provoking in some patients. We now have some excellent, effective and safe intravesical and oral therapies that can provide major relief to a significant number of patients.