Quantitative cultures of the urethral meatus were obtained from women with SCI undergoing intermittent catheterization. When compared with the urethral cultures of a group of female subjects, women with SCI had a greater number of isolates of Klebsiella pneumonia and Pseudomonas aeruginosa in the urethral flora. However there was not a significantly greater number of isolates or log numbers of E. coli or Enterococcus sp. in the urethral flora. The E. coli and Enterococcus sp. isolated from the urine were not isolated from the urethra of female patients with SCI in one third of the patients. This poor correlation between the simultaneous urethral and urine cultures of female subjects with SCI may reflect colonization of the urine with organisms that were unable to adhere to the mucosa and colonize the urethra. To what extent these organisms colonize or are temporary residents may be important in the pathogenicity of the infection.