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Purpose: Faecal incontinence (FI) is a prevalent and important multifactorial condition. Neuromodulation via implanted sacral nerve stimulators is efficacious, but as with other invasive treatment modalities is expensive and associated with significant complications. Peripheral neuromodulation of sacral nerve roots via posterior tibial nerve stimulation (PTNS) is effective in urinary incontinence, but there is minimal evidence for its use in FI. This study aimed to assess the efficacy of PTNS in FI. Methodology: 12 patients with FI of various causes (8 idiopathic, 3 obstetric, 1 previous anorectal surgery) underwent PTNS at a UK hospital. All were investigated with colonic imaging, anorectal physiological studies and endoanal ultrasound. Prior treatments comprised physiotherapy (12), sphincter repairs (3 biofeedback (3) and implants (1). PTNS was performed for 30 minutes, weekly for 12 weeks. Outcome measures were episodes of incontinence, the Hospital Anxiety and Depression Scale and Rockwood Faecal Incontinence Quality of Life score. Results: Mean monthly episodes of incontinence of wind, liquid and solid before treatment were 18.77, 21.77 and 22.15 respectively. After 12 weeks’ treatment this had reduced to 0.92, 0.83 and 0.83 respectively (p < 0.05). Sphincter integrity, physiology and aetiology were not shown to affect efficacy. No patient's incontinence worsened. Non-significant improvements in Anxiety and Depression and quality of life scores were also seen. Conclusions: This is the first UK study to demonstrate PTNS as a potentially efficacious and minimally invasive alternative treatment modality for faecal incontinence. These early results are encouraging, but we await medium and long term follow up. [ABSTRACT FROM AUTHOR]