Introduction and Hypothesis <p>To compare perioperative, anatomical, and functional outcomes of conventional multiport laparoscopic sacrohysteropexy and single-port laparoscopic lateral suspension in women undergoing uterine-preserving surgery for apical pelvic organ prolapse.</p> Methods <p>A retrospective comparative cohort study was conducted in a tertiary referral center with 68 women with symptomatic apical pelvic organ prolapse who underwent uterine-preserving laparoscopic surgery between January 2023 and January 2025. Interventions used included conventional multiport laparoscopic sacrohysteropexy (<i>n</i> = 32) or single-port laparoscopic lateral suspension (<i>n</i> = 36). Both techniques resulted in significant improvement in apical support, with comparable changes in POP-Q point C at 12 months. The single-port lateral suspension group demonstrated significantly shorter apical operative time and reduced hospital stay. Functional outcomes improved significantly in both groups, as reflected by reductions in PFDI-20 scores and increases in FSFI scores. Recurrence rates were low and comparable between groups. However, baseline differences between groups and the non-randomized study design should be considered when interpreting these findings.</p> Conclusion <p>Single-port laparoscopic lateral suspension may represent a feasible minimally invasive alternative to conventional multiport sacrohysteropexy, demonstrating comparable short-term anatomical and functional outcomes with potential perioperative advantages. Further prospective studies are required to confirm these findings.</p>