The study aims to compare the objective and subjective outcomes of laparoscopic sacrocolpopexy (LSC) and transvaginal mesh (TVM) surgery. A retrospective study of 62 women with pelvic organ prolapse stage III and IV among patients who underwent LSC (N = 30) and TVM (N = 32). The pelvic floor quality of life questionnaires (PFDI-20, PFIQ-7, PISQ-12) and the pelvic organ prolapse quantification (POP-Q) were used to assess the subjective and objective outcomes, respectively. The intraoperative details and long-term surgery complications were assessed as well. The patients were reviewed after the operation for a gynecological examination, treatment, and functional outcomes evaluation. Compared to preoperative POP-Q measurement, except for PB and TVL, the postoperative objective outcomes improved significantly for the two groups (P < 0.05). The postoperative mean for PB increased significantly in the TVM group than in the LSC group, 2.75 +/- 0.49 Vs 2.45 +/- 0.68, (P = 0.04), and the postoperative mean for point C was more improved in LSC than in the TVM group, (- 5.68 +/- 2.76 Vs - 5.59 +/- 2.07), respectively. The PFDI-20 questionnaire shows that the post-operative subjective outcomes were significantly improved compared to preoperative status in LSC and TVM (P < 0.05), except CRADI-8 questionnaire for LSC (P = 0.4). The PFIQ-7 improved significantly in TVM (P < 0.05), except CRAIQ-7 (P = 0.5). However, there were no statistically significant in the LSC group (P > 0.05). Patients who went for the LSC procedure had a longer operation time and greater blood loss than TVM. The TVM surgery offered a higher patient satisfaction for colorectal-anal symptoms than LSC. The patients who underwent LSC had a more extended operating time and greater blood loss, while those who underwent TVM had a higher rate of dyspareunia.