Background: Bladder outlet obstruction in females remains a poorly understood condition and is much rarer as compared to males. More difficult is the objective diagnosis of this condition. The wide range in prevalence is probably because of multiple reasons; less reporting by female patients of lower urinary symptoms, empirically treating these patients with urethral dilatation, not suspecting the disease and hence not using uroflowmetry and pressure flow studies. So, the actual prevalence of bladder outlet obstruction in females remains underestimated. Aim: To determine the incidence and etiology of bladder outlet obstruction in female patients. Methods: In this prospective observational hospital-based study a profile of Female patients above18 years with bladder outlet obstruction were included. All the patients underwent detailed clinical history, physical examination, urine analysis, uroflowmetry, ultrasonography as routine. All the patients were subjected to multichannel pressure flow studies. After identification of cause of bladder outlet obstruction as anatomical or functional, appropriate treatment was given to patients ranging from medical treatment to surgical procedure including urethral dilatation, cystoscopy, bladder neck incision, optic internal urethrotomy, urethroplasty, intra-sphincteric botulinum toxin injection, caruncle excision and anterior colporrhaphy. Patients were followed at 2 weeks, 1month and 3 months and response to treatment was monitored by symptom score questionnaire (CLSS symptom score and QOL), PVR (in ml) and Qmax in ml/sec. Results: Out of 54 patients, 31 (57.4%) patients had anatomical cause of bladder outlet obstruction (BOO) and rest 23 (42.6%) had functional etiology of bladder outlet obstruction (BOO). In anatomical group out of 54 subjects, 13 patients (24%) were found to have urethral stricture, 5 (11.5%) had cystocele, 4 (7.4%) had meatal stenosis, 3 (5.5%) had bladder neck stenosis, 3 (5.5%) had atrophic urethritis and 2 (3.7%) had caruncle as the cause of bladder outlet obstruction. In the functional group (n=23), 20 (37%) patients had dysfunctional voiding (DV) and 3 (5.5%) patients had primary bladder neck obstruction (PBNO).