Emphysematous cystitis is a rare potentially life-threatening infection of the urinary tract system commonly caused by gas forming micro-organisms like Escherichia coli. It is commonly seen in diabetics and middle-aged-elderly women. Presenting symptoms could be variable and unusual on many occasions. Therefore, a high index of suspicion is crucial in prompt/accurate diagnosis and treatment of this disease. This case report presents emphysematous cystitis in a middle-aged woman with poorly controlled diabetes mellitus. Pneumaturia and evidence of emphysematous cystitis on computerized tomography were also noted in this case.