Tension free vaginal tape (TVT) is a minimally invasive operation that gained increase popularity at the surgical field for management of patients with stress urinary incontinence. The use of SPMUS (suprapubic midurethral sling) has significantly simplified the surgical procedure and made it safer. OBJECTIVES: evaluation the effictivity of the SPMUS procedure in ladies with stress urin incontinence. PATIENTS AND METHODS:Twenty six female patients were assigned to undergo SPMUS procedure in Al-Sadar Medical City from January 2010 to July 2011. Sixteen of the cases wth pure SUI and ten had mixed UI. The procedures were done either under spinal anaesthesia (SA) or under general anaesthesia (GA). SPMUS implies the placement of a polypropylene tape at the mid-uretha via a minimal vaginal incision. Patients were monitored during outpatient visits at 2 weeks and 3monthly after surgery. RESULTS:The mean follow-up time was 12±1 months (3 to 19 months). avarage surgical time was 35 min (20–50 min). overall complications rate was 42.3%(11/26) . The intraoperative complications rate was 15.4%, including three bladder injuries, and one case of paraurethral hemorrhage . The postoperative complications rate was 26.9% (n=7 cases). Most serious complication was difficulty in urinnation in three ladies which required CIC (clean intermittent catheter) for about 21 days .The de novo urgency had occurred in one women. The objective cure rate about 96.2%. CONCLUSIONS: SPMUS operation is an effective method for the manegment of patients with stress urine incontinence.