On the basis of two casuistics reference is made to the diagnostic difficulties of an aneurysm of the abdominal aorta with urological symptoms. A frequently empty urological anamnesis, oligo-anuria, colic-like pains in the medium epigastrium with pulsating tumour and an increasing acrocyanosis in the region of the lower extremities are an imperative reason to think of an aneurysm of the abdominal aorta, including the two renal arteries.