Single-incision mini-slings (SIMS) are the latest generation of midurethral support for the treatment of stress urinary incontinence (SUI). SIMS were developed attempting to improve upon the traditional midurethral slings (MUS). SIMS have been developed to decrease many risks associated with MUS, including avoidance of passage through the retropubic space and decreased groin pain associated with the lateral trajectory and groin incision of transobturator slings. While there are likely instances in which a reconstructive surgeon may choose a SIMS over a traditional MUS, there is not one ideal candidate, and this device is yet another tool that the surgeon may consider given a particular patient presentation. Therefore, the reconstructive surgeon should be aware of the preoperative, perioperative, and postoperative considerations unique to SIMS. In particular, surgeons should understand various postoperative issues of the SIMS, including failure to treat stress incontinence, rate of reoperation, de novo urge incontinence, urinary retention, mesh exposure, and dyspareunia and pain, and how these risks compare to the traditional MUS. This chapter serves to discuss the unique aspects associated with SIMS. While much additional data has been obtained on the safety and efficacy of SIMS over the last decade, continued long-term studies are still underway.