Numbers of nursing home beds now exceed hospital beds in the United States and are usually occupied by women. Urinary incontinence is very common and may be managed with long-term urethral catheters. Bacteriuria invariably results, yet its clinical consequences are not well known. Westudied 47 catheterized and bacteriuric women for almost 25 patientyears. The incidence of febrile episodes of possible urinary origin was 1.1 episodes/1OO patient-days. Because these were diagnoses of exclusion, even this low incidence may be an overestimate. Most of these episodes were of ⩽38.3 C (101.0 F), lasted for less than one day, and resolved without antibiotic therapy. Six deaths, half the total from all causes, occurred during these episodes, an incidence 60 times that during afebrile periods. Deaths and bacteremias were significantly associated with episodes of ⩾38.8 C (102.0 F). In the individual patient, these risks should be weighed against benefits of patient comfort, family satisfaction, and prevention and management of decubitus ulcers.