Urinary tract infections (UTIs) are common in older people and can lead to serious complications. Infections can worsen underlying medical conditions, adversely affect recovery and be alarming to patients, their families and caregivers. UTIs have a complex pathophysiology but the most common cause is the ascent of bacteria from the periurethral area, which explains their prevalence in older women. As a result of antibiotic resistance, an accurate diagnosis is imperative and should be based on clinical history, presence of typical signs and symptoms and test results. Nurses can assist patients through the diagnostic process, treatment and prevention of UTIs, promoting their wellbeing and empowerment. This article explores the pathophysiology of UTIs and diagnosis, prevention and nursing management in a variety of care settings.