Various types of urethral sling procedures have been advocated in the management of female urinary stress incontinence. We present our technique using a synthetic suburethral sling. The patient is placed in a dorsal lithotomy position and two small suprapubic incisions are made. With a Foley catheter in the urethra, a horizontal incision is made about 1 cm proximal to the urethral meatus. The vaginal mucosa is reflected and the entire length of the urethra is mobilized. A synthetic piece, 1 mm thick by 5 cm long by 1.5 cm wide is used as a urethral sling and a running #2 nylon suture is placed through each end of the synthetic strip. A Stamey needle is used to pass the ends of the nylon suture from the vaginal side up to the abdominal incisions. The strip is placed beneath the reflected vaginal mucosa and is seated underneath the urethra to support the entire urethral length. Then the second #2 nylon suture is passed up thourgh the abdominal incision using the Stamey needle. The placement of the sutures is checked cystoscopically. The sutures are then tied above the rectus fascia, through the abdominal incisions. The vaginal and abdominal incisions are closed in the usual manner. A urethral catheter or suprapubic catheter is used for postoperative bladder drainage.