Background: Stress urinary incontinence (SUI) is a common disorder that affects a large number of women and their quality of life. It is defined as the involuntary leakage of urine on effort or exertion, or on sneezing or coughing according to the standardized terminology of the International Continence Society. Objective: The aim of this study was to compare both the efficacy and safety of the single-incision mini- sling (SIMS) against the traditional trans-obturator (TOT) sling for the surgical management of SUI in women including; objective and subjective cure rates, patient's satisfaction, and complication rates. Patients and methods: This study was a prospective, double-blind clinical trial conducted on 100 women complaining of symptoms of stress urinary incontinence, with or without urge incontinence, based on patient complaint, cough stress test and ICIQ-SF score. Attended the outpatient clinic of the Obstetrics and Gynecology Department of Al- Hussein hospital, Al-AzharUniversity, Cairo, during from March 2016 to March 2019. Results: Regarding the cough stress test after one year follow up, the number of participants who reported negative results showed continuous progress in group (B) [42 women (89%)] after 38 (79.2%) in 6th month visit. On the other hand, group (A) women showed a little drop [44 women (91.7%)] after 46 (93.9%) in 6th month visit. Yet, the two groups showed insignificant difference at this follow up stage (P= 0.74). Conclusion: The 1-year follow-up results of this prospective trial indicate that both procedures appear to be equally effective for the treatment of SUI as regard the objective cure rates, whereas the SIMS procedure showed higher subjective cure rates than the TOT procedure.