Two patients with massive procidentia and 13 patients with posthysterectomy vaginal vault prolapse underwent surgical procedures at Mount Sinai Hospital, Toronto, between May 1978 and February 1986. The standard procedure consisted of an abdominal sacropexy, with use of Marlex mesh to anchor the vaginal vault to the sacral promontory and retroperitonealization of the mesh. In 11 of the 15 patients, one or more concurrent procedures were performed at the same time. There were no intraoperative complications. One serious postoperative complication occurred, and one patient developed recurrent vault prolapse. Follow-up has been from 3 to 93 months with an average of 28 months. In 14 patients (93.3%) subjective and objective improvement was achieved. A review of the literature is presented.