〔Abstract〕 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(ISFF) 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.