Purpose of Review <p>Pelvic organ prolapse (POP) in women of reproductive age presents unique challenges, requiring symptom relief while preserving fertility and uterine function. Although most cases occur postmenopausally, POP also affects younger women, mainly after vaginal delivery, especially with instrumental assistance, prolonged labor, or large infants. Additional risk factors include obesity, multiparity, and connective tissue disorders.</p> Findings <p>Conservative options such as pelvic floor muscle training, biofeedback, and pessaries are typically first-line, with benefits in symptom improvement though evidence on prolapse severity remains mixed. Surgical alternatives, particularly uterine-sparing procedures like sacro-hysteropexy and native tissue repair, show favorable fertility outcomes and are increasingly performed laparoscopically or robotically. POP in pregnancy, while rare, can be managed effectively with conservative approaches to support positive outcomes.</p> Summary <p>Management of POP in childbearing-age women requires an individualized, multidisciplinary approach, balancing conservative and surgical strategies with attention to reproductive goals and long-term health.</p>