Urine microscopy with red blood cells (++++) may be a serious or non-serious condition and needs to be determined depending on the specific cause. A variety of conditions can cause red blood cells (++++) in urine, such as the presence of a tumor in the urinary tract, which can then cause the tumor to break down and bleed, resulting in red blood cells (++++) in urine. This is a more serious situation because the tumor may be malignant and can cause threat to the patient’s life and health or recurrence of distant metastasis, persistent cancer pain in the patient or organ dysfunction. However, bladder stones, ureteral stones, kidney stones or urethritis or cystitis can also cause red blood cells (++++) in the urine. This is not a serious disease, but a common urological disease, through anti-infection treatment, extracorporeal shock wave lithotripsy treatment, etc., after the removal of the original disease, the urine microscopy red blood cells (+ + + +) can be restored to normal. Therefore, microscopic red blood cells (++) need to clarify the specific cause of the disease, and further determine whether it is a serious disease.