OBJECTIVES: The aim of this study was to determine the prevalence, awareness and determinants of urinary incontinence (UI) among Qatari women and the sociodemographic factors involved in their health care-seeking behaviour. DESIGN: A cross-sectional study was used to determine the symptoms of UI experienced by Arabian Gulf women. SETTING: Primary Health Care (PHC) Centres and community-based study in Qatar. SUBJECTS: A multistage sampling design was used and a representative sample of 1000 Qatari women aged 45 years and above were included from January to June 2003. MEASUREMENTS: Participants completed a questionnaire assessing UI in the previous 12 months and health care-seeking behavior for urinary symptoms. RESULTS: Of 1000 women living in urban and semiurban areas who were asked, 798 (79.8%), representing the study sample, agreed to participate and completed the questionnaire. Of these, 164 (20.6%) were found to have UI. Overall, the reason for not seeking medical attention was mainly embarrassment (40.6%) at having to speak with doctor. Of the total study sample, 562 subjects (70.4%) believed that UI was abnormal and worth reporting to a doctor. Coping mechanisms among incontinent women included frequent washing (58.3%) and wearing a protective perennial pad (42.4%), changing underwear frequently (41.3%), decreasing fluid intake (19.8%) and stopping all work (4.9%). Sufferers were most troubled by their inability to pray (64%) and their marital relationship (47%), limitation of their social activities (20%), difficulty in doing housework (14%) and inconvenience during shopping (13%). Most (71.9%) of the incontinent subjects were self-conscious, ashamed of themselves and troubled by guilt (P < 0.001); 56% found it most embarrassing to discuss UI with their husbands. The majority of women (51.9%) believed child birth to be the major cause of UI, followed by ageing (49.5%), menopause (34.2%) and paralysis (25.3%). Most of the subjects (62.3%) believe that UI can cause infection, some (20.5%) believe that it can cause skin allergy and very few think that it can cause cancer or other disorders. CONCLUSIONS: Our findings indicate that although UI is relatively common in the community, it is underreported by Qatari women because of social and cultural attitudes and-most importantly-lack of information. This findings suggest that strategies to promote care-seeking for incontinence must be developed and employed in the community.