Management of pelvic organ prolapse must be individualized. Patients who are candidates for surgical correction should undergo a careful preoperative assessment that includes treatment of contributing medical problems, identification of all support defects, and evaluation of the lower urinary tract function. Surgeons who perform reconstructive procedures for pelvic organ prolapse should be familiar with multiple surgical procedures because intraoperative modification of the preoperative plan may be required. A thorough knowledge of the disorder and its impact on physiologic functions allows the selection of a surgical approach that usually is successful in relieving symptoms and restoring and preserving anatomic relationships, visceral function, urinary function, and coital function on a lasting basis.