Bladder distention is an infrequently reported cause of venous obstruction that may be confused clinically with deep venous thrombosis or congestive heart failure. Urinary symptoms may be minimal or absent. Herein we describe a 73-year-old man with unilateral lower extremity edema caused by a distended urinary bladder. In addition, we review the clinical manifestations of 15 previously reported cases of venous obstruction due to urinary retention. Of the 15 patients, all but 1 had painless bilateral lower extremity edema. In most cases, the cause of bladder distention was benign prostatic enlargement.