Sixty patients presenting with acute urinary retention were randomly allocated to treatment with either suprapubic or urethral catheters. An initial specimen of urine was obtained for bacteriological culture and organism count. Subsequently, repeat specimens of urine were obtained at intervals of 2 days until the catheter was removed. The results of these cultures showed that suprapubic catheters caused less urinary tract infection (p<0.05). In addition, suprapubic catheters were more comfortable for the patients, easier to manage and more cost‐effective. In patients with suprapubic catheters, their ability to void could be assessed prior to removal of the catheter, thus avoiding the need for recatheterization. It was concluded that patients presenting with acute urinary retention should be routinely treated by drainage using suprapubic catheter