In briefAthletes are prone to hematuria from diverse causes, and proper diagnosis hinges on a careful history, physical examination, and urinalysis, as well as on judicious use of screening tests, imaging studies, and cystoscopy. Using six illustrative cases, this article covers the adult athlete with hematuria: real and false, normal and abnormal, microscopic and gross. It focuses on when and how to evaluate hematuria, and offers practical tips on management.