Since time immemorial uroscopic analysis has been a staple of diagnostic medicine. It received prominence during the middle ages with the introduction of the matula. Urinary discoloration is generally due to changes in urochrome concentration associated with the presence of other endogenous or exogenous pigments. Observation of urine colors has received less attention due to the advances made in urinalysis. A gamut of urine colors can be seen in urine bags of hospitalized patients that may give clue to presence of infections, medications, poisons, and hemolysis. Although worrisome to the patient, urine discoloration is mostly benign and resolves with removal of the offending agent. Twelve urine bags with discolored urine (and their predisposing causes) have been shown as examples. Urine colors (blue-green, yellow, orange, pink, red, brown, black, white, and purple) and their etiologies have been reviewed following a literature search in these databases: Pubmed, EBSCO, Science Direct, Proquest, Google Scholar, Springer, and Ovid. 1. Introduction For thousands of years physicians had diagnosed their patients’ illnesses by examining a urine sample [1]. Uroscopy predated even Hippocrates and began during the Babylonian and Egyptian civilizations [2]. About 20 colors had been described even as early as 100？B.C. in some Sanskrit medical texts. De Urinis by Theophilus Protospatharius in the 7th century was hugely influential in uroscopic diagnosis after having demonstrated a range of urinary colors [2]. In the 12th century, Gilles de Corbeil introduced the matula to assess color, consistency, and the clarity of urine. The urine was usually examined under direct sunlight [2]. Occasionally the urine was tasted. The matula became a part of the doctor’s armamentarium and since then, urine examination had been widely used in the diagnosis of diseases [3]. Physicians began carrying a urinal on horsebacks as a professional trademark [1]. Uroscopy achieved a prominent position in diagnostic medicine during the middle ages after the publication of Fasciculus Medicinae by Johannes de Ketham [4]. His illustrated medical text showed a large urine wheel with various urinary shades (~21) that could be matched to a diagnosis [4]. Urochrome gives the normal yellow color to urine [5]. To a lesser extent, urobilin and uroerythrin also contribute towards normal urinary color [6]. Changes in urinary concentration, pH, and metabolic parameters cause color variations in urine [7]. Thudicom characterized the pigment urochrome in the 19th century. Changes in urine color depend on
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