Paruresis is a disorder characterized by the inability or difficulty urinating in the presence of others and avoidance of situations where such problems may be experienced. Although it has been suggested that paruresis is a type of social phobia, the cognitions, behaviors, and physiological sensations which are integral in understanding social phobia have received little attention in the paruresis literature. The present study employed self-report measures of cognitions, behaviors, and physiological sensations to investigate paruresis from a cognitive behavioral perspective. Participants included a paruretic group recruited from the International Paruresis Association (IPA) website and a control group, without paruretic fear, recruited primarily from the University of Wyoming. As predicted the paruretic and control group differed significantly on the majority of cognitive, behavioral, and physiological factors examined. Drawing from the data obtained, and the scientific understanding of social phobia, a cognitive behavioral model of paruresis is proposed.