Purpose: Validate a visual scale to assess LUTS, especially in developing countries, as an alternative to IPSS. VASUS consist of five questions, where Q1 and Q2 assess urinary stream quality, Q3 nocturia, Q4 incomplete emptying and Q5 QoL. Methods: Between 2014 and 2017, we carried out a study in the male population over 30 years from São Tomé and Príncipe, a Portuguese speaking African Country. A stratified sample (age and district) of subjects completed IPSS, VASUS and a free flowmetry. Results: We obtained 812 valid responses (average age: 50.72, range: 30–95 years old). In the comparison between IPSS and VASUS, we found positive correlations, with p value < 0.0001, for all variables analyzed and negative correlation for all urodynamic variables. Upon verifying the association of VASUS with IPSS, namely when comparing questions with similar objectives such as nocturia (VASUS—Q3 and IPSS—Q7), the stream quality (VASUS—Q1 and Q2 and IPSS—Q5) or the quality of life (VASUS—Q5 and IPSS—Q8), strong positive correlations were found. Conclusion: VASUS is a visual alternative to IPSS allowing evaluation of LUTS and having correlation with IPSS and flowmetry. Its use in developing countries with low levels of literacy will be an asset. The authors believe that widespread use of a scale such as VASUS in urology consultations is warranted, to increase daily practice objectification of LUTS.