Pelvic organ prolapse (POP)is a common clinical entity that can significantly impact a patient’s quality of life secondary to symptoms of pelvic pressure, a vaginal bulge, urinary, bowel or sexual dysfunction. It is highly prevalent, with roughly 13% of women undergoing surgery for prolapse in their lifetime. Vaginal prolapse is diagnosed by history and physical examination. Additional testing may be indicated for evaluation of bowel and bladder symptoms. On exam, prolapse can represent descent of the anterior vaginal wall, vaginal apex (cervix/uterus or vaginal cuff scar after hysterectomy), or the posterior vaginal wall, though in many cases represents a combination of these. Treatment options for POP include: observation, pelvic floor physical therapy, pessary use, or surgery. In patients with asymptomatic POP, observation is typically utilized. In those not desiring or medically unfit for surgery, pessaries are an effective non-surgical option. When indicated, surgery can be performed via transvaginal, laparoscopic/robotic, or open approaches, either using the patient’s own tissue or mesh augmentation. Deciding between these is based on the compartment(s) involved, extent of prolapse, medical and surgical comorbidities, differences in durability and risk between surgeries, and in shared decision making with the patient. Here, we review pertinent clinical considerations in the evaluation and management of POP.