We present the case of a 57-year-old man with emphysematous cystitis. The patient presented with a complaint of several days of lower abdominal pain and gross hematuria. Work-up included an abdominal CT scan that revealed gas within the urinary bladder wall, and cystoscopy confirmed diffuse submucosal emphysema throughout the bladder. The patient was treated conservatively with broad spectrum antibiotics, with prompt resolution of both symptoms and radiographic findings. Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients. A conservative treatment approach using antibiotics and bladder catheterization is typically successful, with a complication rate of only 18.8%.