Background: Catheter-associated urinary tract infections (CAUTIs) are common healthcare-associated infections in critically ill patients with indwelling urinary catheters. Prolonged catheterization promotes bacterial colonization and biofilm formation, potentially compromising urine culture accuracy and patient outcomes. Aim of the study: to evaluate the effect of urinary catheter replacement before urine specimen collection on clinical outcomes among critically ill patients. Setting: The current study was conducted at in the General Intensive Care Unit at Sohag University Hospital, Egypt. Sample: A purposive sample of 60 critically ill adult patients with indwelling urinary catheters was recruited in the study. Design: A Quasi-experimental design was used. Tools: I-Demographic and clinical Data Sheet; II- Urinary Tract Infection Assessment sheet and III- Patients’ Outcomes Assessment sheet. Results: The findings demonstrated statistically significant differences between the intervention and control groups regarding several clinical outcomes. Patients in the intervention group had a lower incidence of sepsis, a shorter ICU length of stay, and lower incidence of recurrent urinary tract infections than those in the control group (P = 0.001, P = 0.001, and P = 0.004, respectively). Conclusion: Urinary catheter replacement before urine specimen collection was associated with improved clinical outcomes among critically ill patients as lower incidence of sepsis and recurrent urinary tract infections and a shorter ICU length of stay. Recommendation: Urinary catheter replacement before urine specimen collection may be considered as part of an evidence-based urinary catheter management protocol for critically ill patients requiring urine culture, particularly when clinically indicated.