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Acute urinary retention and constipation precipitated by herpes zoster infection. A 76-year-old man presented to the emergency department complaining of acute urinary retention (AUR) and severe constipation. His recent medical history included 4 days of treatment in the community for gluteal herpes zoster with famciclovir. A transurethral catheter was passed and the patient completed a full course of famciclovir with resolution of constipation. The patient's catheter was successfully removed 3 weeks after his presentation. We report on the clinical presentation and management of an unusual case of AUR and constipation caused by a zoster viral infection of the S2-S4 dermatome.