To evaluate the prevalence and risk factors for pelvic organ prolapse (POP) in Chinese women in Guangdong province, China. A cross-sectional study of 8862 women, aged 20-90 years, was conducted using a stratified cluster sampling technique. Prolapse staging was assessed using the Pelvic Organ Prolapse Quantification system (POP-Q). The overall prevalence of POP was determined, and associated risk factors were investigated using multivariable weighted logistic regression. Of the 8862 women, 399 had a stage II prolapse or higher giving an overall prevalence of 4.5%. Women with symptomatic POP had a higher mean (standard deviation) age than those with non-symptomatic POP at 60.6 (14.7) versus 46.0 (14.5) years, respectively. They also appeared to be heavier [57.5 (6.9) vs. 53.9 (7.3) kg], shorter [153.6 (6.5) vs. 156.5 (5.4) cm], and to have a higher body mass index (BMI) [24.7 (9.2) vs. 22.1 (5.2) kg/m(2)] compared to women with non-symptomatic POP. Multivariable logistic regression analysis identified age (OR: 1.075, 95% CI: 1.060-1.090; p < 0.0001), BMI (OR: 0.966, 95% CI: 0.943-0.989; p = 0.004), family income level (OR: 0.637, 95% CI: 0.496-0.819; p < 0.0001), and pre- or post-menopause status (OR: 0.303, 95% CI: 0.207-0.442; p < 0.0001) as potential risk factors for POP. Conclusions: Symptomatic POP affects a substantial proportion of women in China. Age, BMI, family income level, and pre- or postmenopause status are associated with POP, all of which have the potential to be modified. Greater attention to the diagnosis, treatment and prevention of POP in China has the potential to improve its management.