A series of 76 patients with stress urinary incontinence who underwent the Pereyra needle suspension operation and anterior colporrhaphy is presented. Long-term follow-up of 56 patients showed that almost half developed recurrent incontinence. Postoperative chaincystogram studies demonstrated initial restoration of vesical neck support; a return to abnormal anatomy occurred in a majority of patients, however, at the time of later followup, a change that did not always result in return of the incontinence.