Multiple behavioral and surgical treatments exist for the treatment of stress urinary incontinence (SUI). We report herein on the safety and efficacy of the transobturator vaginal tape inside out (TVT-O) procedure for patients with SUI. A retrospective study of 102 consecutive patients with SUI who underwent the TVT-O procedure was conducted. Pre and postoperative evaluations included urodynamic studies and a 60-min pad test. Based on the 4th and 8th week postoperative evaluations, 97 of 102 (95%) patients had a complete cure. Of 88 patients who were followed for 12 months, 84 (95%) achieved a complete cure. Two instances of intraoperative lateral vaginal sulcus perforation occurred. Pain over the inner thigh was noted in 17 (17%) patients. Mesh erosion was noted in one case. TVT-O procedure is a safe, effective, and minimally invasive procedure for SUI with a low rate of complications.