Pelvic organ prolapse (POP) is a gynecological problem that can worsen the psychosocial, economic, and sexual function of women and often relapses after surgery. POP is associated with weakness of the pelvic floor supporting structures. Pelvic organ prolapse is associated with a reduced quality of life for millions of women worldwide. The purpose of this study was to determine the role of the MMP-1 rs 1799750 gene polymorphisms as a risk factor for pelvic organ prolapse in Balinese women. This observational case-control study involves 30 patients with pelvic organ prolapse as the case group and 30 patients without pelvic organ prolapse as the control group. The study was conducted at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. Three milliliters of venous blood samples were taken from each patient and DNA examination was performed to determine MMP-1 gene polymorphisms. Risk assessment of the MMP-1 gene polymorphism for pelvic organ prolapse was done by controlling for confounding variables, including age, parity, heavy work, body mass index, menopausal status, and history of hysterectomy, through multivariate logistic regression conditional test. Result from this study is the MMP-1 gene polymorphism increased the risk of pelvic organ prolapse 4.33 times compared to non-prolapsed in Balinese women (OR 4.33, 95%CI 1.20 -15.61, p = 0.020). After controlling for various confounding variables, MMP-1 gene polymorphism still increased the risk of pelvic organ prolapse up to 5.52 times (AOR 5.52, 95%CI 1.352-22.50, p = 0.02). Conclusion from this study is MMP-1 gene polymorphism significantly increases the risk of pelvic organ prolapse in Balinese women.