Exercise haematuria is common, usually microscopic and glomerular in origin and possibly related to renal ischaemia. Less common, lower urinary tract bleeding is associated with higher counts of urinary red cells. It usually occurs after longer distance runs and probably is due to traumatic lesions of the bladder. Studies have indicated that exercise associated urinary abnormalities resolve in 24 to 48 hours. If any remain, urinary tract investigations should be performed, guided by interpretation of urinary red cell morphology.