INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare robotic or laparoscopic sacrohysteropexy (RLSH) and open sacrohysteropexy (OSH) as a surgical treatment for pelvic organ prolapse (POP). METHODS: Among 111 consecutive patients who had undergone sacrohysteropexy for POP, surgical outcomes and postoperative symptoms were compared between the RLSH (n = 54: robotic 14 cases and laparoscopic 40 cases) and OSH (n = 57). groups The medical records of enrolled patients were reviewed retrospectively. RESULTS: Compared with the OSH group, the RLSH group had shorter operating time (120.2 vs 187.5 min, p < 0.0001), less operative bleeding (median estimated blood loss 50 vs 150 ml: p < 0.0001: mean hemoglobin drop 1.4 vs 2.0 g/dl: p < 0.0001), and fewer postoperative symptoms (13 vs 45.6 %: p < 0.0001). Patients' overall satisfaction (94.4 vs 91.2 %: p = 0.717) and required reoperation due to postoperative complications (3.7 vs 1.8 %: p = 0.611) did not differ between groups. CONCLUSIONS: RLSH could be a feasible and safe procedure in patients with POP and should be considered as a surgical option that allows preservation of the uterus. Prospective randomized trials will permit the evaluation of potential benefits of RLSH as a minimally invasive surgical approach.