Acute urinary retention has many etiologies. In the pregnant patient, especially at the end of the first trimester, an incarcerated gravid uterus is a rare but possible cause. The patient discussed is a 30-year-old, gravida 4, para 2012, woman who was 14 weeks pregnant and who presented complaining of lower abdominal pain, urinary frequency, urgency, and nocturia. Based on the patient's symptoms, a diagnosis of a urinary tract infection was made, and antibiotic therapy was begun. Her symptoms failed to resolve, however, and she was referred for further evaluation, which eventually revealed an incarcerated gravid uterus. The patient was referred to an obstetrician who re-positioned her uterus without difficulty, and she subsequently had an uneventful pregnancy.