Purpose of Review <p>The mainstay of surgical management for male stress urinary incontinence (SUI) for many years has been the male urethral sling and the artificial urinary sphincter. However, patients with pelvic radiation history are at increased risk for poorer outcomes. This review examines the surgical options for radiated men with SUI, how this history may affect outcomes, and surgical modifications which may optimize results.</p> Recent Findings <p>Male urethral slings demonstrate diminished success but may be considered in carefully selected radiated patients. The artificial urinary sphincter remains the gold-standard for radiated men though with increased risk of complications. Key technical modifications include conservative cuff sizing, selective transcorporal placement, and consideration of lower-pressure pressure-regulating balloons. Ongoing technological innovations may address the challenges in this patient population.</p> Summary <p>Successful SUI management in radiated patients requires careful patient selection, consideration of technical modifications, and thorough patient counseling regarding anticipated risks and realistic expectations.</p>