Abstract Objective: To evaluate the efficacy of posterior tibial nerve stimulation (PTNS) as a treatment for the overactive bladder (OAB) resistant to medical treatment. Patients and methods: The study included 60 patients, comprising 55 women (92%) and five men (8%) with a mean (SD) age of 41.4 (10.8) years, who presented to the Urology Department of Benha University Hospital from June 2010 to October 2012. All patients were assessed initially by taking a history, a physical examination, urine analysis, routine laboratory investigations, and a urodynamic evaluation in the form of flowmetry, cystometry, and a pressure-flow study in some cases. A voiding diary (daytime and night-time frequency, voiding volume, and leakage episodes) was completed by all patients, and all underwent 12 sessions of PTNS using a personal computer-based system, and were reassessed after the sixth session, at the end of the course, and at 3 and 6 months after the last session, using the same methods as in the baseline visit. Results: There was a statistically significant improvement in all the variables assessed. No infection or failure of the PTNS mechanism was detected while usinghe technique, but there were rare instances of minor bleeding and a temporary painful feeling at the insertion site. Conclusion: PTNS is safe, and gives statistically significant improvements in the patient’s assessment of OAB symptoms.