Technologies are generally provided for a trans-urethral sling delivery device for deploying a sub-urethral sling to support a urethra to treat urinary incontinence. A trocar and a delivery tube may be advanced through the urethra, and the trocar may puncture a hole in the urethral wall. The delivery tube may be configured to form a curved position such that a curved portion may extend from the hole in the urethral wall into an area surrounding the urethra near the bladder. A sub-urethral sling may be attached to a flexible delivery tool in a reduced delivery profile, and the flexible delivery tool with the attached sub-urethral sling may be advanced through the curved delivery tube. The delivery tube may be rotated to enable the delivery tool to anchor each end of the sub-urethral sling on each side of the urethra with a portion of the sling supporting the urethra from beneath.