Key content Urethral diverticulum (UD) is uncommon but is underdiagnosed., Imaging is essential before surgery is planned., Missed diagnosis may result in continued symptoms., Surgery for UD is challenging and complications are common., Learning objectives To review the symptomatic presentation of UD., To review the differential diagnosis of a mass in the urethra., To understand how imaging may help in the diagnosis of UD., To review the management of complications of UD., To review the surgical treatment of UD., Ethical issues If not performed adequately surgery may result in a worsening of symptoms especially urinary incontinence., Surgery is difficult and should be performed by specially trained individuals [ABSTRACT FROM AUTHOR]