Objectives: This study was performed to evaluate the different surgical treatment alternatives for urinary stress incontinence and their clinical results. Methods: Of the patients who visited our clinic between January 1989 and June 1994 complaining of urinary stress incontinence, 408 were found to have genuine stress incontinence (GSI) after undergoing clinical and laboratory investigations. These 408 patients were treated with different surgical techniques. Their postoperative results are discussed. Results: After postoperative follow-up, the success rates of the different surgical techniques were as follows: anterior colporrhaphy (Kelly plication) 66.2%, Marshall-Marchetti-Krantz 88.7%, Burch procedure 94.1%, and sling urethropexy 97.5%. Conclusions: Patients with a clear-cut diagnosis of GSI must be surgically treated. There are several different techniques, all of which have advantages and disadvantages. If the right technique is used for the right patient then the success rate is high.