Haematuria, or the presence of blood in the urine, is an important urological symptom. Bleeding sufficient to be recognised by the patient is known as macroscopic haematuria. If associated with pain, it is often benign and usually infective in origin. When painless, it is traditionally associated with malignant tumours of the urinary tract, in general, and of the urothelium, in particular. However, this sharp distinction between painful and painless haematuria is somewhat artificial and a patient with macroscopic haematuria of whatever type needs to be investigated with a view to excluding a malignant cause for that bleeding.