Postoperative urinary retention is a common complication after major orthopedic procedures of the lower limb. In total hip arthroplasty and total knee arthroplasty, the incidence ranges from 7% to 84%. In this study, the incidence and risk factors for postoperative urinary retention were described in a cohort of 376 men undergoing total hip arthroplasty. Postoperative urinary retention was defined as the inability to void after surgery for which single or indwelling catheterization was performed. Risk factors were identified using multivariate regression analysis. Following total hip arthroplasty, 150 (39.9%) of the 376 men developed urinary retention. Patient-controlled analgesia (odds ratio, 4.10; 95% confidence interval, 1.79–9.40), use of spinal anesthesia (odds ratio, 1.79; 95% confidence interval, 1.07–2.99), and age 70 years or older (odds ratio, 1.77; 95% confidence interval, 1.06–2.95) were independent risk factors for urinary retention. Potential risk factors that were not confirmed included body mass index, American Society of Anesthesiologists physical status (Class I–III), hypertension, diabetes mellitus, prostate pathology, smoking, average pain during the first 24 hours after surgery, and length of surgery.