Blood in urine is called hematuria. It can appear as visible red, pink, or cola-colored urine, or it may be detected only on a urine test (microscopic hematuria). This page provides educational, evidence-based information about common causes of hematuria, symptoms that may occur alongside it, how it is typically evaluated in clinical care, and general management considerations.
Educational notice: This content is for informational purposes only and does not replace professional medical advice. If you have symptoms or concerns, consult a qualified healthcare professional.
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What Is Hematuria?
Visible vs. microscopic blood in urine
Visible hematuria means blood can be seen in the urine. Microscopic hematuria means red blood cells are found on urinalysis even though the urine looks normal. Microscopic hematuria is relatively common and may be temporary, but persistent findings usually require appropriate medical evaluation.
Why urine may look red (and not be blood)
Urine color can sometimes change for reasons other than bleeding. Certain foods (such as beets), food dyes, or some medications may cause red or orange urine. Because appearance alone is not reliable, urine testing helps confirm whether blood is present.
Common Causes of Blood in Urine (Overview)
Hematuria can have many possible causes. Some causes are temporary and relatively benign, while others require medical evaluation. The examples below represent common categories discussed in clinical practice.
Urinary tract infection (UTI)
UTIs can inflame the urinary tract and may cause burning with urination, urgency, frequency, pelvic discomfort, and sometimes blood in urine. Learn more about symptoms and evaluation on our Urinary Tract Infections (UTIs) page.
Kidney stones
Stones can irritate the urinary tract and commonly cause hematuria, often with flank pain, nausea, or pain that comes in waves. Learn more about typical symptoms and testing on our Kidney Stones page.
Prostate-related conditions (in men)
In men, prostate enlargement or inflammation can contribute to urinary symptoms such as weak stream, hesitancy, or incomplete emptying, and may occasionally be associated with blood in urine. See Prostate Health for an educational overview.
Bladder conditions and irritation
Bladder irritation or other bladder conditions can be associated with urgency, frequency, discomfort, and sometimes hematuria. For related context, see Bladder Health. If urgency and frequency are prominent, you may also find our guide on Overactive Bladder (OAB) helpful.
Exercise, medications, and other factors
Intense exercise may occasionally be associated with temporary hematuria. Certain medications (including some blood thinners) and underlying medical conditions may also contribute. Because causes vary widely, clinicians evaluate symptoms together with laboratory testing and medical history.
Possible Risk Factors
Some factors may increase the likelihood that blood in urine occurs or that further evaluation is recommended.
- Recent urinary tract infection
- History of kidney stones
- Prostate enlargement or prostate inflammation
- Intense physical exercise
- Certain medications, including anticoagulants
- Smoking history or exposure to bladder irritants
- Previous urinary tract conditions or procedures
Having a risk factor does not necessarily mean a serious condition is present. Clinical evaluation helps determine whether additional testing is needed.
Symptoms That May Occur With Hematuria
Hematuria may occur alone or together with other urinary symptoms. Symptoms themselves do not confirm a diagnosis, but they can help guide evaluation.
Pain, burning, urgency, and frequency
Burning, urgency, and frequent urination are often associated with infections or bladder irritation. Flank pain may suggest kidney or ureter involvement. For a broader framework of urinary symptom patterns, see our Urinary Symptoms overview.
Flank pain, fever, clots, or difficulty urinating
- Fever or chills with urinary symptoms may indicate infection requiring prompt care.
- Severe flank or back pain can occur with kidney stones or urinary obstruction.
- Blood clots in urine or difficulty urinating should be evaluated urgently.
How Blood in Urine Is Evaluated
Evaluation typically begins with a review of symptoms and medical history. A healthcare professional may ask about urine color changes, pain, recent infections, medications, exercise, and any prior urinary conditions.
Medical history and physical examination
Clinicians assess symptom timing, severity, and possible risk factors. They may also evaluate whether hematuria is associated with infection symptoms, kidney stone–like pain, or changes in urinary flow.
Urinalysis and urine culture
Urinalysis helps confirm the presence of blood and may reveal signs of infection or inflammation. When infection is suspected, a urine culture may identify bacteria and guide antibiotic selection.
Imaging and additional tests
Imaging such as ultrasound or CT may be recommended to evaluate for stones, structural abnormalities, or urinary tract obstruction. In certain cases, clinicians may recommend cystoscopy, a procedure that allows direct visualization of the bladder and urethra.
General Management Considerations (Educational Overview)
Management depends on the underlying cause of hematuria. This section is educational only and not a treatment recommendation.
Treating underlying causes
Treatment may focus on managing infection, addressing kidney stones, or evaluating structural or inflammatory conditions. Avoid self-treatment with leftover antibiotics or medications without professional guidance.
Follow-up and repeat testing
Follow-up testing may be recommended if hematuria persists or recurs. A healthcare professional can explain whether additional monitoring or testing is appropriate based on clinical findings.
When to Seek Medical Care
Seek urgent care if you experience
- Visible blood in urine with fever or chills
- Severe flank, back, or abdominal pain, especially with nausea or vomiting
- Blood clots in urine
- Inability to urinate or severe difficulty urinating
- Rapidly worsening symptoms or feeling significantly unwell
If you believe you may be experiencing a medical emergency, contact local emergency services immediately.
Common Questions
Can blood in urine occur without pain?
Yes. Some causes of hematuria may occur without noticeable pain or discomfort. Because painless hematuria can still require medical evaluation, clinicians generally recommend discussing it with a healthcare professional.
Is microscopic hematuria serious?
Microscopic hematuria is sometimes temporary and may resolve on its own, but persistent findings usually require evaluation to rule out underlying causes.
Can dehydration cause blood in urine?
Dehydration itself usually does not cause bleeding, but concentrated urine may irritate the urinary tract in some circumstances. Persistent hematuria should always be evaluated medically.
Medical Disclaimer
The information on this page is provided for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition.
Learn more on our Editorial Policy & Medical Disclaimer page.