The compliance of physicians to current guidelines for asymptomatic microhaematuria is limited and the evidence supporting asymptomatic microhaematuria as an effective screening tool for the early detection of bladder cancer is weak. Medical or surgical treatment is indicated in 13–35% of patients with asymptomatic microhaematuria, albeit mostly for benign conditions, which are more commonly the cause. The high prevalence of asymptomatic microhaematuria in the general population means that this condition poses a considerable challenge to the health-care system.