To ascertain the pattern of presentation, management and incidence of lower urinary tract obstruction (LUTO) in the University of Calabar Teaching Hospital (UCTH), this prospective study was carried out between July 2003 to June 2004. One hundred and fifty five (155) out of a total of 70,139 new patients presented with LUTO giving an incidence rate of 221/100,000. The male:female ratio is 50:1 making LUTO a predominantly male disease. The age ranged from 4-95 years, with a mean of 56.17±17.92. Majority of the cases, 48.4% presented acutely while 38.4% and 13.5% presented as chronic and acute-on-chronic cases respectively. The management basically followed the standard practiced by many urologist in the sub-region and elsewhere.50,61,65,67,70,75 However, the use of modern techniques and facilities was obviously lacking. Complications resulting from the various treatments was generally low judged against a perculiar background of this study. The actual mortality resulting directly from LUTO was noted to be 0.6% which is low. In conclusion, UCTH is a centre with a high incidence of LUTO, but the facilities for quick and appropriate management of patients need to be put in place urgently.