This is a prospective study evaluating the efficacy and safety of the Apogee vault repair system in the management of vault prolapse. All patients who underwent this procedure between October 2004 and December 2005 in Townsville, Australia are included in the study. Preoperative and postoperative clinical assessments were done using the pelvic organ prolapse quantification (POPQ) system and patients were followed up at 6 weeks, 12 weeks, 6 months, 12 months and then biannually. Of the 35 patients operated, there were no intraoperative complications and only one patient (2.8%) had a recurrence of vault prolapse at 12 months. Nine patients (25%) had mesh exposure treated successfully with outpatient trimming and oestrogen. This medium term study shows that the Apogee procedure is safe with minimal complications for the management of vault prolapse.