OBJECTIVE: To determine the respective associations between ureteral obstruction and renomegaly, urine specific gravity (USG), and serum creatinine concentration and to assess the reliability of abdominal palpation for detection of renomegaly in cats. DESIGN: Retrospective case series. ANIMALS: 89 client-owned cats with (n = 29) or without ureteral obstruction and with (30) or without (30) kidney disease. PROCEDURES: Medical records of cats that underwent abdominal ultrasonography at a veterinary teaching hospital from January 2006 through April 2013 were reviewed. Cats were categorized as having ureteral obstruction (obstructed group) or no ureteral obstruction with (KD group) or without kidney disease (NKD group). Renomegaly and renal asymmetry were defined on the basis of mean renal length for NKD cats. Prevalence of renomegaly and renal asymmetry, mean USG and serum creatinine concentration, and abdominal palpation and ultrasonographic findings were compared among the groups. RESULTS: Renomegaly was identified in 2 obstructed cats and 1 KD cat and was not associated with ureteral obstruction. Renal asymmetry was detected in 18 obstructed cats and 11 KD cats. For obstructed and KD cats, the mean USG was significantly lower and the mean serum creatinine concentration was significantly greater than those for NKD cats. Twenty-eight of 29 cats with ureteral obstruction had hypercreatininemia. Abdominal palpation was not a reliable method for detection of renomegaly. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated renomegaly was not associated with ureteral obstruction in cats, and abdominal palpation was an unreliable method for detection of renomegaly. The most consistent abnormal finding for cats with ureteral obstruction was hypercreatininemia.