Disturbances of urinary bladder function are well-recognized problems in diabetic patients and are generally attributed to peripheral neuropathy. Because of the difficulties inherent in the histologic examination of the peripheral autonomic nerves, little is known about the pathology of these nerves. Recently, alterations have been observed in fine axons in the bladder wall in diabetic subjects. Pathologic changes have also been observed in ganglia of the bladder wall. Abnormalities previously described in the autonomic ganglia and nerve trunks of diabetic subjects may also be important in the development of urinary bladder dysfunction.