PURPOSE: To evaluate the effectiveness of perineal ultrasonography in the evaluation of female stress incontinence after surgical management. MATERIALS and METHODS: Perineal ultrasonography was peformed in 19 patients who were surgically treated for stress incontinence, and this was performed in erect position. Nineteen patients were divided into two groups, group A for 11 patients with resolved incontinent after surgery and group B for 8 patients with persistent incontinence even after surgery. Using a sagittal scan of the anterior pelvis at the level of the symphysis pubis, the posterior urethrovesical angle (PUVA) and descent of the bladder neck were measured at rest and during stress (Valsalva maneuver), and these measured values obtained before and after surgery were compared between two groups, group A and B. RESULTS: Postoperative PUVA and descent of the bladder neck were decreased when compared with preoperative values measured at rest and during stress in both groups. There was a statistically significant difference in the postoperative PUVA between two groups (p<0.05). The mean increment of PUVA during stress after surgery was 6.3+/-3.8degreesin group A and 14.6+/-6.4degreesin group B, respectively, showing statistically significant difference (p<0.05). There was also a statistically difference in the mean descent of the bladder neck during stress after surgery between the two groups (p<0.05). CONCLUSION: The measurement and comparison of PUVA and descent of the bladder neck by perineal ultrasonography before and after surgery in patients with stress incontinence offered useful and objective information in evaluating the effectiveness of surgical management in female stress incontinence.the surgical effectiveness in the stress incontinence.