A delirium due to urinary retention confuses both patient and physician. Three patients presented with delirium and/or physical deterioration had a bladder retention. A man aged 82 had delirium and an acute renal failure due to a urinary retention with an enlarged prostate gland. A woman aged 81 had a delirium and a bladder retention due to an atonic bladder. A man aged 71 showed cognitive deterioration and a bladder retention due to a backbone-fracture and faecal impaction. In the elderly it is very important to include urinary retention in differential diagnosis because its presentation can be atypical.