Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in 5 Spanish NHs. UI (measured with Minimum Data Set 3.0.), sociodemographic and health-related variables were collected. Chi- square (or Fisher’s) or Student’s t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6–77.2) and was significantly associated with frailty (PR 1.84; 95%CI 0.96–3.53), faecal incontinence (FI) (PR 1.65; 95%CI 1.02–2.65), anxiety (PR 1.64; 95%CI 1.01–2.66), physical performance (PR 1.77; 95%CI 1.00–3.11) and cognitive state (PR 1.95; 95%CI 1.05–3.60). Statistically significant differences between incontinent-continent groups were found for activities of daily living (ADL) limitations, mobility, quality of life, sedentary behaviour (SB) and handgrip strength. It can be concluded that 2/3 of the residents experienced UI, and its significant associated factors were mainly physical (SB, frailty, physical performance, ADL limitations, mobility, FI and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety and quality of life).