The options for the surgical treatment of rectal prolapse are traditionally divided into the abdominal procedures and the perineal procedures. The perineal procedures include the Altemeier and Delorme operations and the Tiersch anal encirclement. In most studies, they have higher recurrence rates than abdominal procedures, but the reasons for this are not usually considered. This chapter discusses the Delorme procedure, which is often misunderstood and tends to be discarded as an option. This is a shame as it is a good choice for patients with mild prolapse and those with significant morbidities that preclude abdominal surgery.