Study Objective To evaluate the long-term outcomes of laparoscopic colposuspension with bilateral round-infundibulopelvic ligaments after hysterectomy in high-grade uterovaginal prolapse. Design Retrospective analysis of medical records (Canadian Task Force Classification II-3). Setting University clinic center. Patients Fifty-one patients with grade 3 (22 patients) or 4 (29 patients) uterovaginal prolapse. Interventions We performed laparoscopic colposuspension with bilateral round-infundibulopelvic ligaments after hysterectomy in 51 patients with grade 3 or 4 uterovaginal prolapse. Measurements and Main Results After a mean follow-up of 59.0 months (95% CI, 56.3-61.7), 51 patients (100.0%) had no sign or recurrence of prolapse. Postoperative transient abdominal discomfort, voiding difficulty, and vaginal spotting developed in 4 patients (7.8%), 2 patients (3.9%), and 1 patient (2.0%), respectively. Conclusion Laparoscopic colposuspension using bilateral round-infundibulopelvic ligaments after hysterectomy could be an effective surgical option in the treatment of high-grade uterovaginal prolapse.