Background <p>Urinary stress incontinence leads to a decrease in the quality of life of women. Pender's health promotion model discusses how to change one's lifestyle. In some populations,&#xa0;adopting&#xa0;the Pender model and lifestyle improvements have improved people's quality of life.&#xa0;However, limited studies have been conducted on improving the quality of life of people with stress urinary incontinence using models. In this regard, the present study was conducted to determine the effect of group counseling based on the Pender Health Promotion Model on the quality of life of women with stress urinary incontinence.</p> Methods <p>This study is a randomized controlled clinical trial. Seventy women were selected using available methods and then randomly assigned to two intervention and control groups using permutation blocks.&#xa0;Sampling was conducted at two pelvic floor disease specialty clinics, Qaim Hospital and Imam Reza Hospital, Mashhad from May 2022 to September 2022. The intervention group received six group counseling sessions and one individual counseling session based on the configurations of Pender's health promotion model. Data development tools included the Demographic Questionnaire, the Quality-of-Life Questionnaire for Patients with Urinary Incontinence (IQOL), the Questionnaire for Urinary Incontinence Diagnosis (QUID), and the Depression Anxiety and Stress Scales (DASS21).&#xa0;The tool’s validity was confirmed by content validity and reliability using the Cronbach alpha method. In both groups, questionnaires were completed before and immediately two months after&#xa0;the intervention&#xa0;ended. Data were analyzed using SPSS 25 software.</p> Results <p>Before the intervention, there was no significant difference in the two groups' average total score on the quality of life questionnaires (<i>P</i> = 0.945). However, there was a substantial increase in the intervention group's quality of life questionnaires compared to the pre-intervention and control groups immediately following the intervention and over the next two months (<i>P</i> &lt; 0.001).</p> Conclusion <p>Group counseling based on the Pender's health promotion model improves the quality of life of women with stress urine incontinence, and it is recommended that this model be used.</p> Trial registration <p>It is registered in the Iranian clinical trials database under the code IRCT20211216053423N1. Date of first registration: 14/03/2022.</p> Graphical Abstract <p></p>