Objective - to compare the perioperative and long-term results of two apical genital prolapse-correcting operations: transvaginal sacrospinous fixation and laparoscopic sacrocolpopexy. Subjects and methods. The investigation enrolled 71 patients with Stages II-IV apical genital prolapse according to the International Classification of Genital Prolapse (POP-Q), who had been operated on at the Department of Endoscopic Surgery in 2010 to 2013. Sacrospinous fixation was done in 41 patients of older age (62.5±10.9 years) who formed Group 1; 30 patients aged 50±6.1 years (Group 2) were operated on through laparoscopic sacrocolpopexy using a polypropylene prosthesis. The follow-up averaged 2.5 years (19-39 months postsurgery). The investigation compared duration of surgery, complications, length of hospital stay, anatomical and functional results, and quality of life in the patients after the performed interventions. Results. The specific features of surgical treatment (simultaneous operations) in the patients of both groups depended on the concurrence of abnormalities (organic uterine diseases, urinary incontinence, and pelvic floor muscle incompetence) in the examinees. In Group 1, the duration of vaginal sacrospinous fixation proved to be twice shorter than that of laparoscopic sacrocolpopexy in Group 2. The bed-days were similar in the patients of both groups. Their subjective satisfaction with surgical results was as high as 90.2% in Group 1 and 93.3% in Group 2. Analysis of the long-term results (within the first 2 years after surgery) indicated that in Group 1, a recurrence requiring resurgery had occurred in 4 (9.8%) patients, which was less than the published data. The manifestations of urination problems and intestinal dysfunction were similar in both groups. Conclusion. Transvaginal sacrospinous fixation and laparoscopic sacrocolpopexy are effective operations in the treatment of patients with apical prolapse. The former is the operation of choice in treating apical prolapse in older age group patients.