• Rectal prolapse occurs when the entire rectum protrudes through the anal canal; circular folds can be seen below the anal verge.  • Patients often have a history of chronic constipation with straining, impaired sphincter function, and/or pelvic organ prolapse.  • Women (>40 years) are 6× more likely than men to have rectal prolapse, multiparity further increases risk. Peak incidence occurs at 70 years.  • Men with rectal prolapse have disordered defecation and tend to have psychiatric issues or developmental delay.  • Common anatomic abnormalities associated with rectal prolapse include redundancy of the sigmoid colon, lack of normal fixation of rectum, lax or atonic musculature of the pelvic floor.  • Surgery is the mainstay of treatment, via either perineal or abdominal approaches.