Urogenital actinomycosis has always been a rare entity, limited to a few cases in any series. Treatment is highly successful but diagnosis remains elusive owing to low incidence, variable clinical picture, and biopsy and culture uncertainties. The general incidence of actinomycosis is believed to be decreasing in recent years but many infections may go undiagnosed while being suppressed or cured by conventional antibiotic therapy given for other resons. Our incidence of 4 cases of genitourinary and abdominal actinomycosis occurring in a 1-year period is highly unusual but the reasons remain speculative. Prior operation, abortion and induced infection via an intrauterine device were probably contributory. Whatever the case, if our experience is shared by others, genitourinary actinomycosis deserves more prominent diagnostic consideration in the future.