Fesoterodine is in a class of medicines called anti muscarinics. It is used to treat overactive bladder condition. Several generic drug manufactures have reported alternate approaches to this drug molecule, through an intermediate of 5-hydroxy methyl tolterodine. This compound was reacted with isobutyryl chloride to react with phenolic group followed by fumaric acid salt formation to produce the drug. Very few deviated this route. Different strategies followed by different groups are discussed in detail.