Urethral diverticula (UD) are not uncommon, affecting up to 6% of the female population, but are in the majority of cases asymptomatic and of no clinical significance. They are thought to arise as a consequence of infection, obstruction, and subsequent rupture of a periurethral gland. UD often pose a significant diagnostic challenge, as symptoms are largely non-specific and easily confused with other conditions such as bladder pain syndrome and recurrent urinary tract infection. As such, both misdiagnosis and delayed diagnosis are common, to the frustration of both patients and surgeons. Traditional methods of diagnosis, such as voiding cystourethrogram, relied upon urethral catheterization and contrast instillation, and were associated with poor anatomical detail. Recent advances in imaging, particularly magnetic resonance imaging, have improved the diagnosis and staging of UD, and have allowed for more accurate preoperative planning.