Abstract: A system for inserting a tissue anchor during endoscopic or other surgical procedures. The system incorporates an insertion instrument for inserting into a surgical site of implantation an elongated, tissue anchor having, for example, a plurality of barbs outwardly extending from its body and a transverse head situated at its proximal end. The instrument is provided with an elongated needle received in the cannulation of the anchor, and an elongated pusher for pushing the anchor into tissue. The needle and pusher are fixedly attached to a handle and are situated in the lumen of a slidable, distally biased sheath or cannula for maintaining the tissue anchor, needle and pusher in alignment while the handle is pushed. The anchor may be inserted by a single-handed operation of the instrument through a simple pushing motion which causes the sheath to retract simultaneously with advancement of the handle to allow the anchor to be pushed into tissue.