Background <p>This case series aims to investigate pregnancy results and pelvic organ prolapse (POP) recurrence after uterus-sparing laparoscopic lateral suspension (LLS) in fertility-seeking prolapse patients.</p> Methods <p>This is a single-center retrospective patient data review study. Between 2019 and 2025, A total of 125 women underwent LLS for POP stage II–III with predominantly anterior and apical defects. Among the 73 patients of reproductive age, 53 did not undergo tubal ligation, and 11 subsequently became pregnant. These women were followed up for 3–6 months and up to 2–5 years, demonstrating stable anatomical outcomes.</p> Results <p>A total of eleven women experienced a postoperative pregnancy, with one resulting in spontaneous abortion. Ten women proceeded with their pregnancies, and two resulted in premature delivery. All other babies exhibited a weight commensurate with their gestational age. The patients were offered an elective cesarean section in order to preserve the anatomical results of prolapse surgery. All deliveries were conducted via cesarean section, and no intraoperative complications were encountered during the incisions. Evaluations at the three- and six-month follow-up visits were recorded, while long-term outcomes (2–5 years) were obtained through structured telephone interviews after LLS.One patient exhibited a recurrence of apical prolapse.</p> Conclusion <p>Laparoscopic lateral suspension (LLS) appears to be a safe and effective uterus-preserving procedure for women with pelvic organ prolapse who desire future fertility. Pregnancy after LLS can progress normally, and cesarean section may be the preferred delivery mode to minimize recurrence risk. Despite encouraging outcomes, larger and long-term studies are required to validate these findings.</p>