In this piece, Dr. Mickey Karram & Dr. Roger R. Dmochowski discuss how although UTIs have demonstrated widespread occurrence and significant healthcare costs, there is not yet a “gold standard” definition for complicated UTI. To avoid the overuse of antimicrobial agents and their associated issues, it is vital that clinicians evaluate test results in the context of a patient’s overall risk and history of UTIs and current clinical presentation and utilize testing that enables more informed decisions.