We describe a patient with recurrent Escherichia coli urinary tract infection followed by recurrent reactive arthritis. During a 9 year period the patient developed 4 episodes of arthritis. During each attack, triggering infections were thoroughly investigated but no other causative infection was found. Although the urinary tract is not routinely targeted for triggering infections for reactive arthritis, we suggest that urinary tract infections should be included in the diagnostic investigations of patients with acute arthritis.