Backgrounds: Primary bladder repair with a suprapubic catheter is considered to be effective for managing intraperitoneal bladder ruptures, and extraperitoneal bladder ruptures are treated well with catheter drainage alone. I compared the clinical outcomes of intraperitoneal and extraperitoneal bladder ruptures. Methods: I reviewed the charts of 60 patients with bladder ruptures who were admitted to the Department of Urology, Dongguk University, Gyeongju Hospital, during the period from May 1995 to April 2001. Patient characteristics, mechanism of injury, associated injuries, duration of catheter indwelling, and complications were reviewed retrospectively. Results: There were 46 (77%) intraperitoneal and 14 (23%) extraperitoneal bladder ruptures. The mean age of the patients with bladder rupturs was 40.9 years, and the most common causes of bladder ruptures were traffic accidents which were observed in 35 cases (58%). The common injuries associated with bladder rupture were pelvic bone fracture, which accounted for 22 (37%) cases. In all the cases of intraperitoneal ruptures, immediate bladder repair with an in-dwelling catheter was performed, and all the cases of extraperitoneal bladder ruptures were treated by urethral catheter drainage alone. Complications, such as urethral stricture, wound infection, intestinal obstruction, continuous urine leakage, occurred in 7(12%) of the 60 patient, but all the complications were in intraperitoneal bladder ruptures. Conclusions: It seems obvious that operative or nonoperative management according to the type of bladder rupture will give a satisfactory result without serious complications, but complications were more frequent in intraperitoneal bladder ruptures.