To study the effect of contrast of laparoscopic iliopexic ligament with uterine preservation and sacral fixation for treating pelvic organ prolapse. Methods: 105 patients with pelvic organ prolapse were selected and divided into experimental group (n=53) and control group (n=52) by random number table method from January 2020 to December 2022. The patients in the control group were treated with sacral fixation, and the patients in the experimental group were treated with laparoscopic iliopexic ligament with uterine preservation. The changes of perioperative conditions, the degree of organ prolapse, the urodynamics, the sexual function, the scores of pelvic floor disease quality of life questionnaire (PFIQ-7), pelvic floor dysfunction disease related questionnaire (PFDI-20), and pelvic floor organ prolapse on sexual function questionnaire (PISQ-12), and the occurrence of adverse reactions of the patients were compared between the two groups. Results: There were no significant differences in the postoperative residual urine volume and the duration of the hospital stay of the patients between the two groups. The operation time (70.6±17.2 min) and the blood loss (63.5±12.2 ml) of the patients in the experimental group were significantly lower than those (92.4±18.5 min and 86.0±24.8 ml) of the patients in the control group. The degree of organ prolapse of the patients in both groups had increased significantly, and which (67.9%) of the patients in the experimental group was significantly higher than that (42.3%) of the patients in the control group. The satisfaction of sexual function of the patients in both groups had increased significantly, and which (3.91±1.07 points) of the patients in the experimental group was significantly higher than that (2.73±0.99 points) of the patients in the control group. The scores of PFIQ-7 and PFDI-20 of the patients in both groups had decreased significantly, and which (22.35±4.21 points and 13.89±3.44 points) of the patients in the experimental group were significantly higher than those (28.97±5.19 points and 17.59±4.64 points) of the patients in the control group. The score of PISQ-12 of the patients in both groups had increased significantly, and which (39.85±4.14 points) of the patients in the experimental group was significantly higher than that (34.56±3.86 points) of the patients in the control group (all P＜0.05). During the treatment, the main adverse reactions of the patients in the two groups were lumbosacral pain, falling sensation, abdominal tension pain, and abnormal defecation, the total incidence of which (21.2%) of the patients in the control group was significantly higher than that (7.6%) of the patients in the experimental group (P＜0.05). Conclusion: Laparoscopic iliopexic ligament with uterine preservation for treating pelvic organ prolapse is comparable to the sacral fixation, and which has shorter operative time, less blood loss, better sexual function recovery, and lower adverse reaction rate.