Urinary tract infection (UTI) is the most common bacterial infection encountered in the ambulatory care setting in the United States, accounting for 8.6 million visits in 2007. Infections of the urinary tract represent a wide variety of syndromes and may range in severity from urethritis, cystitis, and prostatitis to pyelonephritis. There are several approaches to choose from when using antimicrobial prophylaxis, including continuous prophylaxis, postcoital prophylaxis, and intermittent self-treatment. These have all been demonstrated as effective in the management of recurrent uncomplicated UTIs. Cranberry juice and cranberry supplements are frequently used for UTI prevention. Women are believed to lose the UTI-protective benefits of estrogen after menopause, with resultant increases in vaginal pH and, among other effects, a decrease in introital Lactobacillus colonization. Topical estrogen treatment maybe considered in motivated, postmenopausal women with recurrent UTIs, especially when the risk of prophylactic antibiotic use is high.