Background: Rectal procidentia (rectal prolapse) is a disabling condition. Surgical repair is the treatment of choice for candidates who have a full thickness rectal procidentia. Multiple procedures exist for the repair of rectal procidentia, however; none of them is most effective. Methods: This study was carried out at Minia University Hospital as a prospective non randomized study that compared laparoscopic posterior mesh rectopexy (Group A; n = 20) with Recto-sigmoidectomy (Group B; n = 20) for complete rectal prolapse as regards complications; functional outcomes (constipation and continence) and sexual functions after surgery. Results: The female to male ratio was 3: 2 and their ages ranged from 19-70 years with mean of 41.2 years. The operative time in the resection rectopexy group was significantly longer than the rectopexy group. No significant difference between the two groups regarding intraoperative complications (bleeding only). Resection rectopexy group had statistically significant drop in the constipation score than Posterior mesh rectopexy group with a mean score of 16.9 point(pre) and 2.3point(post) versus a score of 10.3point(pre) and 4.3point(post) respectively. There is no incontinence occurred in mesh rectopexy group but in resection rectopexy group; there were 6 patients developed incontinence with a range 0-20 point and mean 5.4 point The P-Value was 0.007 and it is statistically significant. Sexual functions are preserved in both groups. Conclusion: Although recto-sigmoidectomy seems to affect the continence, it improves constipation scores more significantly in patients with chronic constipation than the posterior mesh rectopexy. Sexual functions will be preserved in both operations.