AbstractBackgroundComplications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion.Case presentationA gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter.ConclusionBowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with lower abdominal scar. The risk may be reduced with the use of ultrasound scan guidance.