In a 6-year period, 9 patients were referred by their General Practitioners to the urology unit with a clinical diagnosis of renal colic but were subsequently found to have leaking abdominal aortic aneurysms (AAA). In all cases of loin pain, especially in the elderly patient, the possibility of a leaking abdominal aneurysm must be considered. If no intrinsic urological cause for the pain is found or patterns suggestive of ureteric obstruction are seen on urography, ultrasound examination of the aorta-iliac vessels should be performed. Magnetic resonance imaging (MRI) and computed tomography (CT) scans may be useful adjuncts to this investigation.