Foreign bodies in the bladder are among the strangest differential diagnoses in the lower urinary tract symptoms (LUTS) and may be missed in initial medical evaluations. We present a 63-year-old man who was visited in the emergency department because of obstructive and irritative lower urinary tract symptoms. Two months earlier, he had a pelvic fracture due to motor vehicle accident and underwent an open reduction and internal fixation of the pubic rami and right acetabulum by an anterior ilioinguinal approach. After initial evaluation, an abdominopelvic X-ray revealed a 3 cm screw in the suprapubic area. He underwent urethrocystoscopy and a 3 cm screw was extracted by forceps.