Genuine stress incontinence is the involuntary loss of urine when intra abdominal pressure increases during certain activities such as coughing, sneezing etc. When evaluating a case of urinary incontinence, it is important to differentiate between the different types and causes. The treatment options for genuine stress urinary incontinence include life style changes and behavioural techniques, medications, periurethral injection therapy and surgery. This essay is concerned with discussing the latest trends in the management of genuine stress incontinence with special emphasis on the different surgical modalities and in particular the safest and most efficient techniques which are the abdominal Burch colposuspension and the sling procedure that is completed vaginally, i.e. TVT and TOT.