Lower urinary tract symptoms (LUTS) and vitamin D deficiency have been thought to be connected, but the association has been inconsistent. Vitamin D receptors have been identified in the bladder, prostate and pelvic floor muscles, and it has been linked to prostate cancer and benign prostatic hyperplasia (BPH). This is a systematic review and meta-analysis of data from 23 studies involving over 86,000 participants. The authors conclude that the odds of LUTS is two to three times higher in individuals with vitamin D deficiency in case-control and cohort studies and 11-37% higher in cross-sectional studies. Conversely, vitamin D supplementation was associated with decreased odds of LUTS in five cohort studies and significant reductions in urinary incontinence episodes in four RCTs. This meta-analysis suggests a significant relationship between vitamin D status and LUTS across multiple study designs. Subgroup analysis suggested that certain populations may be more likely to be negatively impacted by vitamin D deficiency, particularly non-Asian individuals and women.