Clinical, radiological and pathological data of five patients diagnosed to have EC in our institute from July 2005 to December 2010 were retrieved and analyzed. There were four male patients and one female patient with age ranging from 40 to 80 years. Two of these patients presented with lower urinary tract symptoms and three were incidentally diagnosed but had underlying predisposing factors. The patient demographics, management and clinical outcome are given in Table 1. Our first patient was a 40-year-old male who had history of hematuria and severe frequency of urination for three years. He had been evaluated in an outside hospital. Though acid-fast bacilli smear, culture and Mycobacterium tuberculosis-polymerase chain reaction of urine had been negative, he had been started on anti-tubecular therapy (ATT) empirically based on clinical and radiological parameters. Since he did not have any benefit after completion of ATT, he was referred to our institute. His computerised tomography (CT) urography showed bilateral hydroureteronephrosis with narrowing at bilateral vesico-ureteric junctions with a small capacity bladder [Figure 1]. He underwent supratrigonal cystectomy with ileo-ceco-cystoplasty and bilateral ureteric reimplantation. Intraoperatively, there was a thick walled, small capacity urinary badder with inflamed and friable mucosa. Histopathology revealed eosinophilic cystitis showing transmural dense eosinophilic infiltrate and no evidence of tuberculosis [Figure 2]. At three years follow up, patient was doing well and voiding satisfactorily.