Objective. To compare a novel barbed suture, poliglecaprone-25 suture and stapler in Pfannenstiel incisions performed for benign gynecological procedures. Design. A randomized controlled non-inferiority trial with randomization in a 1:1:1 ratio. Setting. Istanbul Dr. Lutfi Kirdar Kartal Research and Training Hospital, Department of Obstetrics and Gynecology. Population. Patients between 18 and 45 years of age without prior lower abdominal incision and undergoing Pfannenstiel incisions for benign gynecological procedures. Methods. A total of 117 female patients randomized into barbed (n = 39), poliglecaprone-25 (n = 39) and stapler (n = 39) groups according to suture type. Skin closure techniques were compared in terms of length of incision (cm), adverse events (wound dehiscence, incisional infection, seroma and hematoma), subjective pain scores, patient satisfaction and postoperative scar cosmesis. Main outcome measures. The difference between three suture materials in terms of postoperative incision pain, patient satisfaction and scar cosmesis. Results. Skin closure techniques were similar in terms of length of incision (cm), adverse events and pain scores and Modified Hollander Cosmesis Score. Barbed (p < 0.001) and poliglecaprone-25 (p < 0.01) sutures were significantly better than staplers in terms of patient satisfaction. Conclusion. The three different methods of skin closure revealed comparable outcome except for a significant superiority of sutures to the stapler method in terms of patient satisfaction scores.