Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease. Symptoms of IC are often exacerbated by bladder filling and are associated with various urinary symptoms. IC is diagnosed by exclusion steps for differentiation from other confusable diseases. The pathophysiology and etiology of BPS/IC is not completely understood. IC is generally assumed to involve changes in the bladder wall as well as alterations in both structural abnormality of pain processing and its modulation. Alterations of the bladder wall at the molecular and structural levels in urothelium along with their adjacent structures have been observed in human patients. Bladder nerves, urothelial cells, and smooth muscles are likely to play an important role through active communication with the immune and inflammatory systems. This review provides recent information on patients with PBS/IC and their abnormalities within the bladder.