There has been recent controversy in the both the media and medical communities regarding the use of trans-vaginal synthetic mesh during prolapse surgery. Recently, the Federal Drug Adminstration (FDA) released a public health notification regarding complications associated with the use of trans-vaginal mesh such as erosion, infection, and pain during intercourse. However, supporters of mesh state that it offers advantages over traditional procedures, including long-term durability and reduced incidence of recurrence of pelvic organ prolapse. Most high volume surgeons who are properly trained using this material would agree that synthetic mesh, when used judiciously, is an essential tool in the treatment of pelvic organ prolapse. However, in choosing a surgery, it is essential that the course of action be individualized, and that the chosen procedure meets a particular patient’s goals, expectations and risk tolerance.