Abstract: Background and Purpose: Comparing transcutaneous effects versus percutaneous tibial nerve stimulation on overactive bladder in postmenopausal women. Subjects and Methods: It was a randomized controlled trial. 60 postmenopausal women with overactive bladder, age were55-65years, divided to3 groups. Control received medical drugs in the form of selective anti Muscarinic drugs (10mg) once daily for 12 weeks. Transcutaneous tibial nerve stimulation (TTNS) group received the same medical treatment and TTNS, 3 sessions/week for 12 weeks. Percutaneous tibial nerve stimulation (PTNS) group received the same medical treatment and PTNS, 3 sessions/week for 12 weeks. Urodynamic investigation system was used to assess volumes in first desire for void and maximum bladder capacities (MBC) and overactive bladder questionnaire short form use for assessment the bladder severity symptoms and health related quality of life (HRQoL). Results Statistical analysis showed that the volume at first desire to void, MBC, and HRQoL significantly increased (P=0.0001) in all groups post treatment, while bladder severity symptoms significantly reduced (p=0.0001) in all groups after treatment. Also, Significantly differences among the control and TTNS in favor of TTNS (p= 0.0001), as well as between the control group and PTNS group in favor of PTNS (p= 0.0001) in all variables. However, no significantly differ (P>0.05) among TTNS group and PTNS group after treatment in all variables. Conclusions: TTNS is as effective as PTNS in decreasing bladder severity symptoms and improving HRQoL in postmenopausal women with overactive bladder.