|Obstetric fistula, the consequence of tissue ischemia with subsequent pressure necrosis, occurs when a woman with obstructed labor has inadequate access to obstetric services. It is a devastating maternal complication. The Global Burden of Disease Survey of 1990 conservatively estimated 654,000 women living with obstetric fistula worldwide with 262,000 of these cases living in Sub-Saharan Africa. More recently, Wall estimated that at least 3.5 million women suffer with fistula with 130,000 new cases developing each year. Growing attention to the obstetric fistula, paired with an inadequate number of facilities that specialize in fistula repair, has led to surgeons from industrialized nations travelling to assist in the repair of these fistulas. Volunteer surgeons working in developing nations perform an estimated 7,000 surgeries annually. The International Organization for Women and Development (IOWD) fistula program at the National Hospital of Niamey, Niger assembles surgical teams to work with an established Nigerien team for the repair of obstetric fistula. The objective of this article is to describe diagnostic procedures and surgical techniques utilized for the repair of various types of obstetric fistula.