To evaluate the effect of vaginal transobturator tape (TOT) on female stress urinary incontinence (SUI) and sexual function. Patients and methods: In all, 145 patients with SUI underwent TOT repair using the ‘outside–in’ technique. All patients had been sexually active in the previous 6 months. Patients were evaluated by history, routine laboratory investigations, cough stress test, abdominopelvic ultrasonography, and full urodynamic studies. The preoperative data assessed included: age, parity, body mass index, menopausal status, and Stamey grade of SUI. The intraoperative data assessed included: operative time, blood loss, and hospital stay; intra- and postoperative complications were also assessed. At 2 weeks after discharge, patients were followed-up with a routine examination and cough stress test. After 6 months’ patients were assessed by urodynamic studies, maximum urinary flow rate, post-void residual urine volume. The following questionnaires were completed before and at 6 months after TOT insertion: International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF), Urogenital Distress Inventory-Short Form (UDI-6), and Female Sexual Function Index (FSFI).