Mycobacterial organisms are responsible for tuberculosis and leprosy. Both are spread by droplet infection from the lung and can rarely involve the uro-genital tract. Tuberculosis may affect any part of the male or female urinary, or genital, tracts whilst leprosy predominantly affects the renal parenchyma; both spread predominantly haematogenously from the lungs. Improvement in living conditions and nutrition can help decrease the spread of both infections but when clinically evident they require treatment, usually, with multi-drug treatments to avoid the development of bacterial resistance.