Background: SUI is one of the most distressing medical diseases among adult women, with a direct influence on the physical, psychological, and social well-being of those affected. Behavioral, medicinal, and surgical therapies are used in the treatment. Over the last two decades, there has been substantial advancement in SUI surgery. Methods: From February 2018 to February 2020, 50 female patients with stress urine incontinence (SUI) were randomly assigned to one of two groups in the current prospective randomized research. Group A received an autologous coated sling, whereas Group B received a synthetic sling. History, voiding diary, physical examination, cough stress test, symptom score (ICIQ-UI-SF), and cystometry are used to assess patients. The major outcome metric was sling erosion and severe complications. The efficacy was examined scientifically by the cough stress test and qualitatively by (ICIQ-UI-SF). Results: There were no statistically significant differences in patient characteristics. Three cases of vaginal erosion in Group B without erosion in Group A were important in terms of safety. The ICIQ score declined significantly after 24 months in both groups, to (0.200.5) (3.925.31), with a very significant difference after 24 months with lower scores in group A. The operating duration in Group A was much longer40.313.9) than in Group B (22.47.1). At 24 months, groups A and B showed 98.9% and 78.6% subjective improvement, respectively. Based on the cough stress test, the objective improvement rate at 24 months was 96% for Group A (24 patients) and 88% for Group B (22 patients). Two patients in Group A had transitory urine retention, two instances in Group A and one in Group B had de novo urgency, and two cases in Group A and one in Group B had groin pain. Conclusion: On a 24-month follow-up, the unique autologous tissue coated tape outperformed synthetic tape in terms of efficacy and safety.