Objective: To observe the Effects of Vaginal Hysterectomy with Anterior-Posterior Vaginal Wall Repair versus Total Laparoscopic Hysterectomy (TLH) with Anterior-Posterior Vaginal Wall Repair and Vaginal Vault Suspension on Pelvic Floor Function in Patients with Uterine Prolapse. Methods: A total of 80 patients with uterine prolapse who underwent surgery in our hospital from June 2022 to April 2025 were selected and randomly divided into the experimental group and the control group, with 40 patients in each group. The surgical protocol for the control group was vaginal hysterectomy with anterior-posterior vaginal wall repair, while the surgical protocol for the experimental group was TLH with anterior-posterior vaginal wall repair and vaginal vault suspension. Surgical indicators, ultrasound parameters of pelvic floor muscle, urodynamic indicators, and quality of life were compared between the two groups. The occurrence of complications during 3 months of follow-up were statistically analyzed. Results: surgical time of the experimental group was longer than that of the control group (P<0.05). At 7 days postoperatively, both groups showed an increase in vaginal vault distance and bladder neck distance, along with a decrease in levator hiatus area. Moreover, the experimental group exhibited higher vaginal vault distance and bladder neck distance, and a lower levator hiatus area compared to the control group (P<0.05). At 3 months postoperatively, maximum urethral closure pressure (MUCP), maximum urethral pressure (MUP), and abdominal leak point pressure (ALPP) increased in both groups, and the values were higher in the experimental group (P<0.05). The Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ-7) scores decreased in both groups at 3 months postoperatively, and the experimental group got lower scores than the control group (P<0.05). The overall incidence of postoperative complications in the experimental group compared to the control group showed no statistically significant difference. (P>0.05). Conclusion: TLH and anterior-posterior colporrhaphy combined with suspension of the vaginal stump is conducive to the recovery of pelvic floor structure and can improve urethral closure function, and enhance postoperative quality of life without increasing surgical risk.