Pubic osteomyelitis typically occurs after pelvic surgery or trauma. We present a case of pubic osteomyelitis ensuing from a chronic indwelling (for 8 years) urethral catheter in a 40-year-old woman. She presented initially with fever of unknown origin, and broad-spectrum antimicrobial therapy was initiated. Computed tomography of the abdomen and pelvis ultimately revealed cortical destruction of the pubic symphysis, and open biopsy confirmed osteomyelitis. Osteomyelitis of the pubis is a rare entity that typically results from bacteremia, trauma, or the spread of an adjacent focus of infection from previous pelvic surgery. To our knowledge, this is the first report of pubic osteomyelitis resulting from a chronic indwelling urethral catheter.