Sterile pyuria is an increased content of leukocytes in the urine in the absence of bacteria. Occurs in at least 10 % of patients with urination disorders on an outpatient basis and in a hospital. Most often it is regarded as a manifestation of the inflammatory process and accompanied by the appointment of unreasonable antibiotic therapy. The article provides data on the causes of sterile pyuria, an algorithm for the actions of a doctor when it is detected, shows the expediency of a special examination for sexually transmitted diseases, tuberculosis. The concept of clinically significant pyuria is proposed when the content of the number of leukocytes is more than 10 in the field of view of the microscope.