Sacrocolpopexy (SCP) is a well-established surgical procedure used to address apical pelvic organ prolapse (POP) in women. Traditionally performed through a larger laparotomy incision, SCP has evolved with the advent of minimally invasive techniques, including laparoscopy and, more recently, vaginal natural orifice transluminal endoscopic surgery (vNOTES). The vNOTES approach offers several advantages over traditional methods, including superior cosmesis, reduced risk of hernia formation, decreased postoperative discomfort, and faster recovery [1]. This chapter focuses on the vNOTES technique for sacrocolpopexy, highlighting its variations, benefits, disadvantages, risks, and clinical considerations.