The use of synthetic materials in pelvic reconstructive surgery is increasing. Abdominal sacral colpopexy with permanent, type I mesh is a durable and safe operation to treat apical prolapse. The incorporation of synthetic materials during surgery to correct anterior and posterior prolapse has variable anatomic results, with several studies demonstrating moderate rates of mesh-related complications. Procedural kits for vaginal placement of synthetic materials are becoming popular, though long-term outcome and safety data are lacking.