Worm-like blood clots in urine, a form of gross hematuria, often indicate significant underlying health issues in the urinary tract. These clots can result from various conditions, including urinary tract infections, kidney stones, bladder or kidney cancer, and glomerulonephritis. Trauma, blood disorders, certain medications, and prostatitis are other potential causes. Identifying the root cause typically involves a combination of urinalysis, imaging studies, and sometimes cystoscopy or biopsy. Prompt medical evaluation and treatment are crucial to address the underlying condition and prevent complications.