ObjectiveTo compare postoperative anatomic cure rates in women treated with bilateral sacrospinous ligament fixation (SSLF) or unilateral SSLF for pelvic prolapse. Secondary outcome measures of morbidity were compared.MethodsOne hundred and three women with pelvic prolapse treated surgically between July 1, 1990, and September 31, 1999, were divided into two groups: patients with bilateral SSLF (n = 62) and patients with unilateral SSLF (n = 41). Demographic, clinical, and outcome data were compared.ResultsThere were similar anatomic cure rates regardless of SSLF type (37/41 women [90.2%], unilateral, compared with 53/62 [85.5%], bilateral;P= 0.56). Specific anatomic defects occurred with similar frequencies between the groups. Women in the unilateral SSLF group had more blood loss and longer operative times than did those in the bilateral group. There were similar rates of transfusion, readmission, cystitis, postoperative incontinence, urinary retention, febrile morbidity, and length of stay between the two groups.ConclusionUnilateral and bilateral SSLF techniques produce similar rates of anatomic cure.