To analyze the utility of perineal ultrasound in the evaluation of female urinary incontinence.The present study was conducted on 50 women with urinary incontinence. The distance between the bladder neck and symphysis pubis with and without stress was measured by perineal ultrasound. A displacement of the bladder greater than 10 mm was considered cystocele, and if the bladder neck and urethra formed a funnel greater than 13 mm, it was considered urinary incontinence.The distance between the bladder neck and the symphysis pubis in all 50 patients ranged from 10 mm to 18 mm (mean 12.8 mm) without stress and from 15 mm to 42 mm (mean 32.6 mm) with stress (Valsalva maneuver and/or cough). Perineal ultrasound was useful in all cases since one could evaluate the descent of the angle of the bladder neck in the case of cystocele and a lesser or greater funneling of the urethra, which is an essential sign in urinary incontinence.Perineal ultrasound can determine which patient has a cystocele, urinary incontinence or both. It is useful in the evaluation and follow-up of patients undergoing surgery for urinary incontinence.