Aim <p>The effectiveness of EMG-BF in SUI has not yet been proven. This study aimed to the effectiveness of EMG-BF on pelvic floor muscle activity, pad test, severity of complaints, and quality of life in female patients with Stress Urinary Incontinence (SUI).</p> Methods <p>In this randomized, placebo-controlled study, 60 women diagnosed with urinary incontinence were divided into three groups: pelvic floor muscle training (PFMT), EMG biofeedback (EMG-BF), and placebo EMG-BF. EMG-BF and Sham EMG-BF applications were applied 3 days a week for 8 weeks, for a total of 24 sessions The King’s Health Questionnaire (KHQ) and International Incontinence Questionnaire (ICIQ-SF), and 1-hour Ped Test were evaluated. Pelvic floor muscle activity was measured with EMG. All measurements were made at the beginning, at Week 8 and at Week 20.</p> Results <p>No significant improvement was found in the control group in all parameters of ICQ_SF (p&gt;0.05), while significant improvement was found in the EMG-BF and Sham EMG-BF groups (&lt;0.001 for each). In the Pad test EMG-BF and Sham EMG-BF groups showed significant improvement compared to the control group (p&lt;0.001). In EMG values ​​in EMG-BF and Sham EMG-BF groups (p&lt;0.05), while no significant improvement was observed in the control group. (p&gt;0.05)</p> Conclusion <p> Adding EMG-BF therapy to PFMT exercises is effective on pelvic floor muscle activity, quality of life, frequency and amount of urinary incontinence. PFMT exercises alone did not have an effect on general health perception, role limitations due to incontinence, physical and social limitations, and personal relationships either. </p> Clinical trial registration <p>After ethics committee approval, clinicaltrials.gov registration was made before patients were recruited into the study. (Clinical Trial NCT05366426)</p>