Background: Cysticocele-associated stress urinary incontinence (SUI) is a prevalent condition among women that can have significant negative impacts on their overall well-being. In order to treat this condition, numerous surgical procedures have been implemented, such as anterior colporrhaphy (AC) and the transobturator four-arm mesh technique. Objective: This study aimed to compare AC and four arms mesh for the surgical treatment of anterior vaginal wall prolapse (AVWP) associated with SUI. Methods: This cross-sectional study was conducted on 50 women who had cystocele-associated SUI in the Obstetrics & Gynecology Department of Benha University Hospitals. All patients were allocated into 2 equal groups: group 1 (n=25) who were treated with transobturator four arms mesh and group 2 (n=25) treated with AC. Results: The findings of the research indicated that age, sex, and comorbidities as well as preoperative SUI grades did not differ significantly between the two groups. However, significant differences were observed in cystocele stage, total ICIQ score, general health perception, role limitation, physical limitation, operative time, and hospital stay. No significant differences were found in postoperative symptoms, postoperative SUI grades, and early complications. Conclusions: Both surgical procedures are effective methods to manage AVWP in patients with SUI and cystocele. The selection between the transobturator four arms mesh technique and AC should be based on cystocele stage, general health perception, and operative time, among other considerations.