Urethrovaginal fistula (UVF) is an uncommon complication after sub-urethral sling placement. This is a report of a 51-year-old woman with stress urinary incontinence who underwent a tension-free vaginal tape (TVT(R)) in July 2001. Thirty-nine months after the procedure, she complained about pelvic and vaginal pain, bleeding from the vagina and stress urinary incontinence. The gynecological examination revealed a large mid UVF hidden by a 1 cm granuloma. The UVF was closed using simple sutures after removal of the sling. No subsequent treatment was performed.