Introduction: Delayed examinations of alkaline pH urine samples will affect xamination results quality for the microscopic urine sediment elements. The organic elements of urine sediment in alkaline and aqueous (hypotonic) urine in delayed examination will cause the cells in urine sediment to be damaged quickly within 2 hours after specimen collection. Purpose: The aim of the study was to evaluate the effects of delayed examination in alkaline pH urine samples (pH> 7.5) using conventional method on alterations in organic elements of urine sediment. The type of research was a laboratory experiment. Methods: Six urine samples from adult males and females inpatients with alkaline pH were performed immediate urine sediment examination, delayed examination within 1 hour, 2 hours and 3 hours after urine collection using conventional methods at room temperature in the clinical pathology laboratory Prof. Dr.W. Z. Johannes, Kupang. Results: The repeated anova test results (p> 0.05) revealed that delayed examinations of alkaline pH urine samples did not affect changes in leukocyte organic element of urine sediments. Friedman test results (p <0.05) revealed that delayed examinations of urine samples of alkaline pH might affect changes in erythrocyte and epithelial organic elements of urine sediments in 3 hours delay. Conclusion: The results of this study showed that there was no effect of delayed examination of alkaline pH urine samples using conventional method on organic elements of leukocyte urine sediments, but altered the examination results for erythrocyte and epithelial organic elements of urine sediments in 3 hours delay at room temperature.