The objective is to compare robotic sacral colpopexy (RSC) utilizing autologous fascia lata to RSC with synthetic mesh in the treatment of pelvic organ prolapse. MethodsWe performed a prospective non-randomized case comparison trial at a single institution.We compared RSC utilizing either synthetic mesh or autologous fascia lata in women with symptomatic pelvic organ prolapse, stages II through IV. The primary outcome was anatomic prolapse recurrence determined by the Pelvic Organ Prolapse Quantification (POP-Q) exam. Secondary outcomes included patient reported outcomes such as the Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7).Complications were also recorded and categorized using the Clavien-Dindo system (CD).