OBJECTIVE: This study aimed to assess the efficacy and safety of sacral nerve root magnetic stimulation (SNRMS) combined with solifenacin in female patients with overactive bladder (OAB) symptoms. METHODS: A total of 183 female patients with OAB symptoms were prospectively randomized into 2 groups. Ninety-two patients in the combination group accepted SNRMS and solifenacin therapy and 91 patients serving as control accepted only solifenacin therapy. The lower urinary tract symptoms, OAB questionnaire (OAB-q) health-related quality of life (HRQoL), symptom bother score, and overactive bladder syndrome score (OABSS) were compared between the two groups at the end of the second, fourth, and eighth weeks. RESULTS: The incidence of lower urinary tract symptoms, including urgency, frequent urination, and incontinence episodes, was significantly lower in the fourth and eighth weeks in patients of the combination treatment group than those in the solifenacin group ( CONCLUSIONS: The combination therapy of SNRMS and solifenacin demonstrated significant improvements over solifenacin monotherapy in reducing OAB symptoms in female patients, providing a higher QoL without increasing bothersome adverse effects.