Urinary tract infections (UTIs) occur frequently, especially in women, with a tendency to recur. Recurrent UTIs (RUTIs) are commonly managed with intermittent or prolonged antibiotics therapy, not always with satisfactory results and increasing the risk of antibiotics resistance. In this context, alternative drugs for RUTIs are arising great interest. Intravesical instillations of hyaluronic acid (HA), alone or with chondroitin sulfate (CS), represents another strategy for the treatment of RUTIs, based on the re-establishment of the glycosaminoglycans layer of the bladder epithelium. Previous studies and meta-analyses, comparing HA with placebo or the standard prophylaxis, seem to confirm the positive effect of HA. Instillations performed weekly for four weeks, and then monthly for 5 months, may reduce the occurrence of RUTIs and increasing the time to first UTI recurrence. On the other hand, intravesical instillations of HA+CS has also been tested in women with bladder pain syndrome/interstitial cystitis (BPS/IC) with promising results. A reduction in pain intensity has been observed after 6 months of weekly instillations of HA, with favorable safety and acceptable cost-effectiveness profile. Intravesical instillation of HA±CS may be a promising and feasible treatment option for patients with RUTIs and BPS/IC. Further research with randomized controlled trials with larger sample size is needed to confirm it.