Introduction and hypothesis: In this study, we define the histopathological features of female urethral diverticula and attempt to elucidate its pathogenesis and etiology. Methods: We analyzed 22 clinical records of women diagnosed with urethral diverticula. We collected clinical, surgical, and pathological data. Pathological re-assessment was performed using hematoxylin-eosin and van Gieson stains. Results: The predominant epithelial types were squamous (41.9%), columnar (31.8%), combined squamous and columnar (18.2%), and cuboidal (13.6%). There was no case of the transitional type. Epithelial ulcerations were present in nine cases. The diverticular wall was composed only of fibrous collagen tissue in all cases. Inflammatory signs were noted in 77.3% of specimens. Conclusions: Histopathological features of female urethral diverticula match the criteria for paraurethral cysts. Concomitant use of synthetic meshes should be avoided due to the possibility of an infectious etiology. Transvaginal excision of the sac is recommended, while transurethral procedures are contraindicated.