OBJECTIVE Our purpose was to review the long-term (5 to 10 years) clinical and urodynamic outcome in patients with stress urinary incontinence after Burch colposuspension. METHODS A follow-up of 87 women with stress urinary incontinence who had a Burch colposuspension between 1979 and 1985 at the Department of Obstetrics and Gynecology, University of Berne, was performed by clinical and urodynamic reevaluation of the patients. RESULTS Stress incontinence was cured in 81.6% of patients. The cure rate was not significantly related to age, hormonal status, body weight, or previous surgical procedures for incontinence. Burch colposuspension stabilized the urethrovesical junction. Urodynamic measurement at follow-up compared with the preoperative evaluation showed in the cured group a significant increase in (1) the functional urethral length at rest and at stress, (2) maximum urethral closure pressure at stress, and (3) pressure transmission. On the contrary, in unsuccessful operations none of the recorded parameters had improved. Women with failed surgery had significantly lower preoperative maximum urethral closure pressures at rest and at stress, lower continence areas, smaller functional urethral lengths at stress, smaller length to peak pressures, and lower index values of urethral relaxation at stress. The procedure had a low operative and postoperative morbidity, with no significant disturbance of voiding function noted at 5 to 10 years' follow-up. CONCLUSIONS Our results with the Burch colposuspension showed a high success rate at 5 to 10 years' follow-up. The high cure rate and low operative and postoperative morbidity were related to careful preoperative selection.