We determined the prevalence of symptomatic and asymptomatic urethral gonorrhoea among men who have sex with men (MSM) at our Australian sexual health clinic. Asymptomatic MSM are screened using the Roche Amplicor((R)) PCR, whereas culture is used for symptomatic MSM. We analysed data from all MSM tested for urethral gonorrhoea from March 2006 to July 2008. Among the 4453 asymptomatic MSM, there were two (0.04%) diagnoses of urethral gonorrhoea, compared with 38 (3.13%) among 1213 symptomatic MSM. Despite a high prevalence of symptomatic infection, asymptomatic urethral gonococcal infection was extremely uncommon among MSM seen in our sexual health clinic.