Background: Urinary incontinence is a common disorder among women that negatively affects health and quality of life. Biofeedback has been introduced as an adjunctive approach to improve PFMT effectiveness. This study aimed to systematically review the evidence regarding the role of biofeedback in optimizing PFMT in women with urinary incontinence.

Methods: This systematic review followed the PRISMA 2020 guidelines. A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2017 and 2026. Randomized controlled trials investigating biofeedback combined with PFMT in women with urinary incontinence were included. Methodological quality was assessed using the modified Downs and Black checklist, and risk of bias was evaluated with the RoB2 tool. Due to heterogeneity among studies, results were synthesized narratively.

Findings: Twelve studies were included in the final analysis. Most studies reported that PFMT combined with biofeedback improved pelvic floor muscle strength, reduced urinary incontinence severity, and enhanced quality of life. Some studies also reported improved self‑efficacy and exercise adherence. However, several studies found no significant differences between PFMT with and without biofeedback.

Conclusion: Biofeedback may be a useful adjunct for improving the performance of pelvic floor muscle training in women with urinary incontinence, although its additional benefit over PFMT alone remains inconclusive.