Background: The aim of this study was to compare the outcomes of vaginal hysterectomy with McCall culdoplasty and transvaginal mesh surgery in the management of female pelvic organ prolapse. Methods: We compared anatomical and functional outcomes who underwent vaginal hysterectomy with McCall culdoplasty or transvaginal mesh surgery for anterior and apical vaginal prolapse at a single tertiary center from January 2009 to December 2016. Anatomical outcome was measured by POP-Q stage and functional outcomes were measured using three questionnaires: the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Surgical treatment was done with POP-Q stage > III and anterior or apical compartment prolased patients. Total follow up legnth is two years for each surgical groups. Results: We compared anatomical and functional outcomes in 154 women who underwent vaginal hysterectomy with McCall culdoplasty (n = 80) or transvaginal mesh surgery (n = 74) for anterior and apical vaginal prolapse at a single tertiary center from January 2009 to December 2016. In this retrospective cohort study, no significant differences in anatomical and functional outcomes were observed at 1- and 2-year follow-up between women who underwent McCall culdoplasty or transvaginal mesh surgery, except for total vaginal length. There were no statistical differences between the two groups for postoperative complications like POSUI (transvaginal mesh operation vs hysterectomy with McCall culdoplasty, 17.5% vs 22.5%, respectively, P = 0.651), urinary urgency incontinence (9.4% vs 8.7%, P = 0.48), overactive bladder (4.0% vs 10.0%, P = 0.147), urinary tract infection (0% vs 2.5%, P = 0.21) or recurrence rate (12.3% vs 2.5%, P = 0.155). Conclusion: There were no anatomical or functional differences in outcome between vaginal hysterectomy with McCall culdoplasy and transvaginal mesh surgery.