Well-designed randomized controlled trials (RCTs) have the potential to provide high-quality evidence to inform questions of therapy and prevention, but this potential is contingent on the use of appropriate methods and transparent reporting. To systematically assess the quality of urology RCT reporting and identify trends over time. All RCTs published in four leading urology journals in 2013 were identified and compared to a prior analysis of studies from 1996 and 2004.