Rectal prolapse (RP) is a condition with major invalidating impact on the quality of life of patients affected. The only curative treatment is surgery. Many different surgical procedures are practiced, and within Europe laparoscopic ventral mesh rectopexy (LVMR) is the procedure of choice, but there lacks evidence and consensus on the optimal surgical management. Previous RCTs within this area have failed due to problems with recruitment, equipoise, and follow-up. Earlier trials have also been focusing on recurrence rates as main outcome, but patients rate quality of life and functional outcomes higher. With recent controversies over the use of mesh combined with a growing number of procedures due to higher percentage of elderly, the need for evidence-based practice is more important than ever.