Female stress urinary incontinence is a highly prevalent condition. Multiple treatment options exist, both nonsurgical and procedural, each with a unique risk/benefit profile. The use of periurethral bulking agent injections is associated with a low risk of morbidity, albeit with lower long-term efficacy compared to the other available surgical treatments. The most common complications following periurethral bulking agent injection are related to voiding symptoms in the post-operative period, such as new onset urinary urgency, dysuria, hematuria, or urinary retention, which are transient and typically resolve with conservative management. Rarely, additional local reactions, such as periurethral hematoma, sterile abscess, or transvaginal or transurethral erosion, can occur, at times necessitating surgical intervention. In addition, urethral bulking agent injections may lead to future misdiagnosis of periurethral masses in patients presenting with lower urinary tract symptoms. Herein, we present a review of the early and later onset complications following periurethral bulking agent injection.