Objective: The aim of this study was to evaluate the effectiveness and safety of minimally invasive surgical procedure trans-obturator vaginal tape (TOT) in the treatment of female stress urinary incontinence and follow up these cases for 24 months regarding effectiveness, safety and possibility of complications. PATIENTS: 30 women with genuine stress urinary incontinence (SUI) demonstrated by history, clinical examination and urodynamic study. METHODS: 30 patients diagnosed with SUI underwent transobturator sling (inside-out technique) (TVT-O Gynecare ®, Johnson& Johnson, USA.) The patients were followed up for 24 - months regarding subjective and objective cure rates. RESULTS: The mean operative time (min.) was 19.67 (±8.06). The mean intraoperative blood loss (ml) was 80±30.52. There was no case complicated by intraoperative bleeding (mild or severe), bladder, urethral, vascular injuries and anesthetic complications. Subjective and objective cure rates of these patients were (95%) both. Conclusion: The results of this study concluded that management of genuine stress urinary incontinence by transobturator vaginal tape (TVT-O) is an easy and safe method with low complications and high success rate.