Objective:To investigate the curative effect of transvaginal sacrospinous ligamentopexy combined with traditional per-vaginam surgery in the treatment of moderate and severe pelvic organ prolapse.Methods:A total of 125 patients with moderate to severe pelvic organ prolapse admitted to the Third People′s Hospital of Yancheng from June 2021 to May 2023 were retrospectively selected as the study objects. They were divided into two groups according to the surgical methods. The observation group (73 cases) received transvaginal sacrospinous ligamentopexy combined with traditional per-vaginam surgery, and the control group (52 cases) received traditional Yin surgery. The primary outcome was anatomic cure rate between the two groups, and the secondary outcome was surgical index, quality of life and recurrence.Results:There were significant differences in the anatomical cure rate [78.1%(57/73) vs 61.5%(32/52)] and postoperative hospital stay between the observation group and the control group at 6 months after surgery (all P<0.05). There was no significant difference in operation time, amount of blood loss and pain degree 24 h after operation between the two groups ( P>0.05). There was no significant difference in Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20) scores between the two groups before operation ( P>0.05). PFDI-20 scores in both groups were lower than those before surgery 6 months after surgery, and PFDI-20 scores in the observation group were lower than those in the control group, with statistical significance ( P<0.05). After follow-up, 3 cases (8.3%) recurred in the observation group and 6 cases (13.3%) in the control group. There was no statistical significance in the recurrence rate between the two groups ( P>0.05). Conclusions:Transvaginal sacrospinous ligamentopexy combined with traditional per-vaginam surgery can effectively treat moderate and severe pelvic organ prolapse, improve the quality of life of patients, and have a good long-term effect.