Red blood cell in urine detected only by the microscope is called microscopic haematuria. As defined by the number, microscopic haematuria can further be classified as significant and otherwise. The shape of the red blood cell may reveal the origin; either glomerular or not. Stones in the genitourinary system can also cause microscopic or gross haematuria of non-glomerular in origin. Of course, double pathology resulting in microscopic haematuria consisting of two types of red blood cells may co-exist. Persistent microscopic haematuria, albeit insignificant to start with, need to be regularly monitored because it can be the earliest evidence of a progressive and deadly disease like neoplasm of the genitourinary system. Seeking advice from a urologist is the best option.