Urinary tract infection (UTI) is an exceedingly common outpatient problem, accounting for more than 8 million office visits and $1 billion in health care costs per year. Approximately 50% to 70% of women will have a UTI sometime during their lifetimes, and 20% to 30% of women will have recurrent episodes (1–3). Thus, safe and effective management strategies that have the potential to improve patient convenience and decrease costs are of considerable interest to patients, providers, and health care organizations. The most well-studied and commonly accepted approach to managing recurrent UTIs uses low-dose antimicrobial prophylaxis given postcoitally, three times per week, or daily (4–6). This strategy has been shown to be safe and highly effective, even after 5 years of use. However, studies of the natural history of recurrent UTI demonstrate substantial variability in the number of recurrences experienced per woman (range, 0.3 to 7.6 episodes per year) (7). In addition, recurrences often cluster in time. Thus, continuous prophylaxis may result in unnecessary antimicrobial use in women who have infrequent recurrences or clustered recurrences. An alternative strategy, namely patient self-diagnosis and self-treatment of recurrent UTIs, may decrease antimicrobial use and improve patient convenience. However, this strategy has been evaluated in only two previous studies, both in relatively small groups of older women referred to specialty clinics for management of recurrent UTI (8–9). To establish the safety and feasibility of this approach in a larger and more generalized sample, we assessed the accuracy of self-diagnosis and the cure rates seen with self-treatment of UTIs in 172 women who had a history of recurrent infection and were attending a university-based primary care clinic.