Urinary schistosomiasis (US) causes chronic ill health and caused by the blood fluke Schistosoma haematobium. This disease is endemic in Africa and eastern Mediterranean countries, and has a predilection for the male gender. This is a 64-year-old farmer (swampy farming and fishing) for more than forty years, that was referred from a peripheral health care centre for abdominal and pelvic ultrasonography on account of abdominal pain and discomfort, bilateral loin pain, dysuria, and terminal hematuria for close to a year duration of onset. The ultrasonography demonstrated bladder wall thickening, mucosal thickening and polypoid proliferation in to the bladder lumen, irregular echogenic crust in the bladder base, suspended mobile echoes in urine most likely from hematoma and/or cystitis, there is associated mild-moderate biliterate dilatation of the pelvi-calyceal systems and ureters(hydroureteronephrosis). The remaining abdominal and pelvic organs appeared normal. Urinary parasitology demonstrated the ova of Schistosoma haematobium confirming the diagnosis of urinary schistosomiasis. We report the ultrasonographic features of urinary schistosomiasis because of its peculiar presentation and to emphasize importance of ultrasound in its assessment.
