OBJECTIVE To review the results of a modification of the transvaginal needle urethropexy as a treatment for patients developing recurrence after surgical correction of stress urinary incontinence (SUI). SUBJECTS AND METHODS Twelve women who had undergone previous surgery for SUI and had developed recurrence of the symptoms were treated by a needle urethropexy technique which employed an island of in situ vaginal skin as a sling to support the bladder neck and urethra. RESULTS After a mean follow-up of 17.3 months, eight of the patients obtained excellent results, three experienced improvement and one was a failure. CONCLUSIONS The vaginal wall sling needle urethropexy was a simple technique to perform and carries a low morbidity. The results are similar to those of the more elaborate traditional sling procedures reported in the literature.