Midurethral synthetic slings for female stress urinary incontinence are minimally invasive polypropylene mesh tapes, which are inserted under the midurethra with trocars. In the last decade this new technology has become the most commonly performed procedure for female stress urinary incontinence, replacing the traditional open procedures. Using only 3 small incisions, these outpatient procedures can be performed under local anesthesia with conscious sedation. Retropubic and transobturator approaches will be reviewed along with a review of efficacy, comparative studies, complications, and use in many different clinical situations.