The new minimally invasive technique for surgical treatment of female stress urinary incontinence via a transobturator approach is designed to reconstitute the urethral support sling while preserving the retropubic space. One of the advantages of this technique is that it avoids the risk of bladder injuries, frequently observed during passage of TVT into the prevesical space, particularly when it has been previously operated. However, recent anatomical studies have shown that bladder injuries may still occur with the use of this new transobturator approach. The present case is the first published case reporting a bladder injury during transobturator insertion of TVT.