Colpocleisis is an effective, obliterative procedure for women with significant pelvic organ prolapse (POP). The procedure is minimally invasive due to its completely vaginal approach and may be performed under local or regional anesthesia, if desired. It can be performed with the uterus in situ or on post-hysterectomy apical POP. Intraoperative complications are infrequent but can include hemorrhage, injury to nearby pelvic structures, and conversion to laparotomy. Significant life-threatening complications are rare and are typically associated with the patient’s overall baseline health status. Preoperative evaluation should focus on identifying occult stress urinary incontinence (SUI), which may become bothersome if not addressed at the time of colpocleisis surgery. Finally, extensive counseling is recommended regarding the postoperative shortening of the vaginal canal. While infrequent, the loss of vaginal intercourse has been cited as a major reason for regret after surgery.