A retrospective chart review of all fistula cases referred to the urogynecology department of King Fahad Medical City, Riyadh, Saudi Arabia, from January 2005 to July 2011, to review their causes, management, and outcome. Medical records were reviewed and analyzed. Fourteen genitourinary fistula cases were identified; eight (57.1 %) cases of vesicovaginal fistula, three (21.4 %) cases of vesicouterine fistula, and three (21.4 %) cases of vesicocervical fistula. Mean age was 41 (+/- 9.5) and mean parity was 7 (+/- 4). Out of the 14 cases, 10 (71.4 %) were obstetrical surgical complications, of which 7 (50 %) were complications of cesarean sections. Ten cases (77 %) cured after primary surgical repair, two (15.4 %) after secondary repair and one after tertiary repair. Most genitourinary fistulae were iatrogenic obstetric caused, unlike causes of fistulae in developing or developed countries.