Background: Ill-defined chronic symptoms such as itching, burning, urethral discharge, and pelvic pain are not uncommon in male urologic patients. Often, microscopic urinalysis, bacterial cultures, and laboratory testing are non-contributory. We have developed a technique for sperm sedimentation and used the cytologic examination of the sediment routinely in more than 4,000 patients with urologic complaints over the last 5 years. Case: We present 3 exemplary cases, documenting the diagnostic power of sperm sediment cytology (SSC). In all 3 cases, conventional laboratory testing failed to reveal a causative agent. Case 1 is that of a 28-year-old male patient with a history of occasional swelling of the lymph nodes in the left inguinal region for 1 year. Case 2 is that of a 51-year-old male patient with a history of itching and burning of the urethra of 2 months' duration. Case 3 is that of a 22-year-old female patient with copious vaginal discharge after intercourse for 18 months, non-responsive to treatment. Conclusion: We were able to identify causative pathologic organisms in the sediment of all patients or their partner. Subsequent specific treatment did clear and alleviate the symptoms documenting the clinical relevance of this new technique. In our experience, SSC has proven to be a valuable technique for diagnosing occult urologic infections.