In patients with apparent urinary tract infection, clinical presentation and results of physical examination and a few simple laboratory studies can identify patients who need urine culture and/or imaging studies and can guide initial therapy. A wide variety of effective antibiotics are available for various causes, and local patterns of microbial sensitivity and cost-effectiveness help govern drug selection. Response to therapy governs further treatment and follow-up. Exclusion of complicated infection and particular risk factors permits simplified but effective management of symptomatic recurrent infections.