BACKGROUND: Chronic urinary retention (CUR) is a common urological emergency. Initial management involves the drainage of the bladder by urethral catheterization. Relief of CUR may be associated with some complications such as post decompressive haematuria, post obstructive diuresis, hypotension, sepsis and electrolyte derangements. The two primary methods of emptying the obstructed bladder are rapid and gradual emptying. The method of relief of CUR to reduce these complications has been debated for decades. OBJECTIVE: To compare the risk of post decompressive complications following rapid versus gradual urinary bladder decompression in patient with chronic urinary retention. METHODOLOGY: This was a prospective, randomized study in which patients with chronic urinary retention were randomized into two groups: A and B. Group A had rapid urinary decompression with 18fr urethral catheter attached to a urine bag, while group B had gradual decompression using a urethral catheter attached to an intravenous fluid giving set which was then attached to urine bag. Post decompressive complications in each group were assessed at designated times and documented based on research protocol. DATA ANALYSIS AND RESULT PRESENTATION: Data was analyzed using the Statistical Package for Social Sciences (IBM) SPSS version 21. Data was summarized by descriptive statistics. The two arms were compared for similarities in demographic variables. Continuous and categorical variables were compared using student t- test and Pearsons‘ Chi – square respectively. Results of analysis were presented with the aid bar chart and tables for clarity. Significant p value was 0.05. RESULT: Sixty patients were recruited into the study and randomized into group A (rapid urinary decompression) and B (gradual urinary decompression) with 30 patients in each arm of xv the study. The mean age was 70.92 ± 13.98 years (range 20 – 96 years). The mean age of the patients recruited into group A was 68.50 ± 14.77 years while that of group B was 73.33 ± 13.19 years. P value = 0.187. Fifteen patients (50%) developed gross haematuria in group A as compare to 7 patients (23.3%) in group B with statistically significant p value of 0.032. Four (26.7%) of the patients with gross haematuria had blood transfusion in group A while only 1 (16.7%) of the patients with gross haematuria in group B had blood transfusion. P value of 0.920y. The highest pints of blood transfused to a patient in group A was 4 pints. The only patients that had blood transfusion in group B had 8 pints. Thirteen patients (43.33%) had post obstructive diuresis in group A compared to 15 patients (50%) in group B. p value of 0.584. Diuresis resolved within 24 hours in 9 patients (30%) in group A and 11 patients (36.7%) in group B. p value of 0.999. The mean reduction in systolic blood pressure was 8.21 ± 2.63mmHg in group A and 7.63 ± 2.14mmHg in group B. p value of 0.583. The mean reduction diastolic blood pressure was 3.84 ± 1.31mmHg in group A and 3.41 ± 1.16mmHg in group B. P value of 0.624. No patient in both groups developed hypotension (BP of <90/60)