Introduction: Urethral caruncles are the most frequent benign tumors of the female urethra. The etiology and pathogenesis of urethral caruncle are not well understood but many theories have been proposed. Case presentation: We report a case of a 72 years old woman with chief complain of pelvic pain. Physical examination revealed a polypoid lesion at the posterior lip of the distal urethral mucosa. The patient underwent a total excision of the urethral caruncle under regional anesthesia Conclusion: Urethral caruncle should be differentiated from other urethral lesions, such as urethral prolapse, periurethral gland abscess, or other benign or malignant neoplasm