The prolapse of the vaginal vault is an annoying complication of the abdominal or vaginal hysterectomy that can appear months or years after the surgery. The vaginal fixation of the vault to the sacrospinal ligament is an alternative to correct the prolapse of vault or genital prolapse. This is a description of the results of the fixation of vaginal vault to the sacrospinous ligament in 130 patients who underwent this procedure in four centers of gynecological surgery of Medellin, from 1991 to 2002. Follow up was possible in 78 patients. 32 of the 78 patients (41%) had previous gynecological surgery, and therefore a diagnosis of vaginal vault prolapse. 46 patients (58%) had pelvic herniation. Complications happened in 13% of the patients, all considered minor complications. In the patients followed between 6 months and 5 years satisfactory results were observed in 100% for support of the vaginal vault. Twelve % presented relaxation of the anterior vaginal wall, with symptomatic cystocele. No recurrence of vaginal vault prolapse was seen. Follow up information was not available for 40% of patients of the study as they could not be located. The average days of hospital stay was of 1,7. The fixation of the vault to the sacrospinous ligament may be an efficient and safe alternative for patients with prolapse of pelvic vault or pelvic hernia.