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The objective of this retrospective study was to gain a better understanding of patient and care factors that may contribute to urinary retention in critically ill trauma patients. Fifty trauma patients over a 1-year period with an International Classification of Diseases, Tenth Revision (ICD-10) code for urinary retention were identified and analyzed. Most patients had an indwelling urinary catheter placed on admission, and it was reinserted in 39 patients. Male gender, orthopedic trauma, and anesthesia were possible contributing factors for urinary retention in our sample population. The use of paralytics and more than one operative intervention had a significant relationship with prescribing bladder medications. It is imperative to have protocols based on best evidence to guide management of urinary retention in this critically ill trauma patient population.