Background <p>This study aimed to examine whether stress urinary incontinence (SUI) was associated with kinesiophobia in women with postmenopausal osteoporosis.</p> Methods <p>This cross-sectional study included 83 women diagnosed with postmenopausal osteoporosis, including those with SUI (<i>n</i> = 47) and those without (<i>n</i> = 36). Participants’ kinesiophobia level was evaluated using the Tampa Scale of Kinesiophobia (TSK), and their mood was assessed using the Hospital Anxiety and Depression Scale (HADS), which includes two subscales: the HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D). SUI severity was evaluated with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and the effect of SUI on quality of life was assessed via the Incontinence Quality of Life Scale (I-QOL). Independent-samples t-tests were used for between-group comparisons, Pearson correlation analyses were used to assess associations between variables, and hierarchical and multiple linear regression analyses were conducted.</p> Results <p>The groups are similar in age, bone mineral density, and HADS-A scores. The HADS-D (<i>p</i> = 0.004) and TSK (<i>p</i> = 0.032) scores are higher in the SUI group. A positive correlation is found between the ICIQ-SF and TSK scores (<i>r</i> = 0.59, <i>p</i> &lt; 0.001). According to hierarchical multiple linear regression analysis, adding the SUI as variable to the model further increased the explained variance in the TSK score by 7.3% (<i>p</i> = 0.008). The ICIQ-SF score was associated with the TSK score (B = 0.52, <i>p</i> &lt; 0.001).</p> Conclusions <p>These findings support considering SUI as one of several clinically relevant factors in the evaluation of postmenopausal osteoporosis, particularly in relation to kinesiophobia and comprehensive patient assessment.</p>