Although approximately 2 million women suffer from an obstetric fistula, the surgical literature is sparse. This review examines the evidence published to date. The most relevant surgical evidence is included, highlighting the need for further scientific investigations to contribute to our surgical practice. The most pressing needs relate to antiincontinence techniques and complex obstetric fistula repairs. K E Y W O R D SFistula repair; Global women's health; Obstetric fistula; Vesicovaginal fistula