Objective. - To evaluate complications of sacrospinous ligament fixation. Design. - Monocentric retrospective study. Setting. - Department of Obstetrics & Gynecology, La Conception University Hospital, Marcella. Patients and methods. - Between January 1991 and September 2002, 277 women (mean age 64.9 years, range 37 to 92 years) underwent a sacrospinous ligament fixation; 91% had a menopausal status, and 15.5% used hormone replacement therapy. 33.2% of the patients had prior hysterectomy, 28.9% had a history of surgery for prolapse, and 18.8% had associated symptoms of stress urinary incontinence. In all cases, sacrospinous ligament fixation was performed under visual control using conventional stitch. Sacrospin ous ligament fixation was combined with the following procedures: anterior vaginal repair (N =137), additional incontinence surgery (N =31), vaginal hysterectomy (N =137), levator myorraphy (N =203). Main outcome measures. - Intraoperative complications, postoperative complications, long term painful symptoms. Results. - Intraoperative complications were represented by 1 case of vascular wound and four rectal injuries. Main postoperative complications were vaginal haematomas (N =6) and abscesses (N =2). Long term symptoms were perineal pain, sciatic neuralgia, and dyspareunia. Discussion and conclusion. - There was no surgical mortality, and we noted low rates of major complications. Sacrospinous ligament fixation assumes high priority in our therapeutic regimen. Objective. - To evaluate complications of sacrospinous ligament fixation. Design. - Monocentric retrospective study. Setting. - Department of Obstetrics & Gynecology, La Conception University Hospital, Marcella. Patients and methods. - Between January 1991 and September 2002, 277 women age 64.9 years, range 37 to 92 years) underwent a sacrospinous ligament fixation; 91% had a menopausal status, and 15.5% used hormone replacement therapy. 33.2% of the patients had prior hysterectomy, 28.9% had a history of surgery for prolapse, and all of the 18.8% had associated symptoms of stress urinary incontinence. In all cases, sacrospinous ligament fixation was performed under visual control using conventional stitch. Sacrospin ous ligament fixation was combined with the following procedures: anterior vaginal repair (N = 137), additional incontinence surgery (N = 31), vaginal hysterectomy (N = 137), levator myorraphy (N = 203). Main outcome measures. - Intraoperative complications, postoperative Results of Intraoperative complications were represented by 1 case of vascular wound and four rectal injuries. Main postoperative complications were vaginal haematomas (N = 6) and abscesses (N = 2). Long term symptoms were perineal pain Discussion and conclusion. - There was no surgical mortality, and we noted low rates of major complications. Sacrospinous ligament fixation assumes high priority in our therapeutic regimen.