Urinary tract infections are a common cause of morbidity and mortality in older adults. Urinary tract infections often present with subtle and atypical symptoms in older women and men. Asymptomatic bacteriuria, when repetitively treated with antibiotics, contributes to a high rate of antibiotic resistant organisms. Clinical practice guidelines have been developed and recently updated for the evaluation and treatment of asymptomatic bacteriuria, complicated and uncomplicated urinary tract infections, and catheter-associated urinary tract infections. When a documented urinary tract infection meets the guideline criteria for treatment, therapy is based on the location of infection (upper versus lower tract disease), host factors (complicated and uncomplicated individuals), and the likely causative agent and local resistance patterns. The presentation, diagnosis, and management of asymptomatic bacteriuria, complicated and uncomplicated UTIs, recurrent UTIs as well as catheter-associated UTIs will be discussed along with factors unique to the older adult population and males that may alter treatment. Prevention strategies can be useful to avoid recurrent urinary tract infections. These strategies will also be discussed.