Described are implants and tools for use in treating pelvic conditions such as incontinence, including urinary incontinence in a male or female, for example an incontinence sling and delivery system that can include a sling implant and delivery tool system, wherein the implant can include a mesh sling and one or more anchors provided at or extending from a portion of the sling to facilitate tissue fixation; the delivery tool system can include at least a tunneler having a lumen, and an insertion tool; and wherein useful methods can involve inserting the tunneler through an incision and into a pelvic region of a patient, connecting the insertion tool to the sling, and inserting the sling into the tunneler to place the sling to provide tissue support.