Objective : To explore the safety and effectiveness of transvaginal ischia spinous fascia fixation for pelvic organ prolapse. Methods : The retrospective analysis of 124 patients who underwent surgical treatment for stage III - IV pelvic organ prolapse was conducted. Among them , 53 cases of transvaginal ischia spinous fascia fixation (IS⁃ FF) were performed as a study group (ISFF group) while 71 cases of transvaginal sacrospinous ligament fixation (SSLF) were performed as a control group (SSLF group) . The operation time , postoperative hospitalization days , preoperative and postoperative hemoglobin values , indwelling urinary catheter time , postoperative pain scores , and the occurrence of complications were compared between the two groups , and the efficacy of the operation was objectively evaluated by using the staging method of pelvic organ prolapse (POP⁃Q) . Also the scores of the pelvic floor impact questionnaire⁃7 (PFIQ⁃7) , the pelvic floor dysfunction questionnaire⁃20 (PFDI⁃20) , and the questionnaire of quality of life 12 (PISQ⁃12) were used to evaluate the patients ′ postoperative quality of life. Results : The operation time and postoperative hospitalization days of patients in the ISFF group were less than those in the SSLF group , and the differences were statistically significant (P < 0. 05) . The preoperative and postoperative hemoglobin values , retention time of urinary catheter, postoperative pain scores , and hospitalization costs of patients in the two groups were compared , and the differences were not statistically significant. At the 3 ⁃month postoperative outpatient follow⁃up , the objective success rate was 100% in two groups. The median follow⁃up time of patients in both groups was 24 months ( 12 - 41 months) , and there were 2 cases of recurrence in the ISFF group , with a recurrence rate of 3. 77% and a subjective success rate of 96. 23% . While there were 3 cases of recurrence in the SSLF group and 2 cases of loss of visit , with a recurrence rate of 4. 34% and a subjective success rate of 95. 65% . 1 patient in the SSLF group presented with a pelvic hematoma with a diameter of about 5 cm after surgery. The hematoma disappeared after hemostasis and other symptomatic treatment. There was no organ injury or blood transfusion in both groups. Conclusion Transvaginal ischia spinous fascia fixation is a safe and effective treatment for pelvic organ prolapse , and it has the advantages of short operation time , fast postoperative recovery , fewer complications , and improvement of patients ′ quality of life.