Background <p>The aim of this retrospective clinical study is to assess clinical outcomes and patient satisfaction between laparoscopic lateral suspension (LLS) with mesh and laparoscopic high uterosacral ligament suspension (LHUS) for apical prolapse with or without anterior prolapse.</p> Methods <p>Patients who underwent LLS with mesh or LHUS from 2019 to 2023 at the Second West China Hospital of Sichuan University were enrolled in this retrospective study. The objective outcomes were evaluated on the basis of the anatomical success rate according to the Pelvic Organ Prolapse Quantification System (POP-Q). The subjective outcomes were assessed using the Pelvic Floor Distress Inventory (PFDI-20) questionnaire, Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Global Impression of Improvement (PGI-I) scores, and complications rate. Complications were defined according to the Clavien–Dindo scale. The outcomes of the postoperative 3, 6, and 12&#xa0;months were analyzed retrospectively.</p> Results <p>The objective and subjective outcomes indicated improvements in both groups. There was no statistically significant difference between the two groups in the change of subjective outcomes. The short-term objective and subjective outcomes for both techniques were found to be comparable. The anatomical success rate for apical and anterior prolapse was 93.85% in the LHUS group and 93.44% in the LLS group at a median follow-up of 12&#xa0;months. LLS demonstrated a superior effect on the degree of postoperative point Ba (the distance from the most protruding point to the hymen on the anterior vaginal wall) improvement compared with LHUS.</p> Conclusions <p>LHUS and LLS are both effective, safe surgical techniques for the treatment of apical prolapse, with or without concomitant anterior prolapse, exhibiting low complication rates and high short-term anatomical cure rates. LLS demonstrated certain advantages over LHUS in terms of anterior prolapse improvement and symptom relief.</p>