Objective: This study aimed to compare the efficacy of the Contasure-Needleless (C-NDL) technique with the Transvaginal Tension Free Vaginal Tape-Obturator (TVT-O) technique in the surgical management of stress urinary incontinence (SUI). Methods: This prospective observational study was performed on adult women with urodynamic proved SUI who failed or declined conservative treatment between August 2017 to October 2019. The cough Stress test was performed for all patients, and they underwent urodynamic evaluation preoperatively. Follow-up visits were performed at one month, six months, and 12 months after surgery. For statistical analysis, we used the Statistical Packages for Software Sciences (SPSS) version 21. Results: Forty patients were divided equally into two groups (TVT-O subgroup and C-NDL subgroup). Regarding the operative time and pain scale, there were no significant differences between both groups (p= 0.078 and 0.054). A higher blood loss was observed in the TVT-O group than the C-NDL group (p= 0.001). At three, six, and 12 months of follow-up, no significant difference was observed in terms of the cough test (p= 0.4708, 0.7256, and 0.6644). Moreover, there was no significant difference in terms of complications (all p>0.05). Regarding the relationship between Valsalva leak-point pressure and cough stress reflex at the last follow-up visit, we detected a significant difference among the studied patients (p= 0.001). Conclusions: C-NDL is a promising technique for treating SUI cases, with low complication rates and a good patient satisfaction level. Furthermore, the procedure's efficacy holds encouraging results that need to be affirmed and tested by long-term outcomes.