Introduction: Laparoscopic lateral suspension (LLS) with mesh is indicated for the treatment of apical prolapse. However, clinical data of this technique still remain limited. Objective: To evaluate the clinical outcomes and changes in the vaginal axis of LLS with mesh for apical and anterior prolapse. Design: Retrospective single center clinical study. Setting: Conducted at the department of Obstetrics and Gynecology, West China Second University Hospital, China. Sample: Ninety-seven patients underwent LLS between 2020 and 2024. Methods: Retrospective analysis. Main Outcome Measures: Anatomical success rate, subjective cure rate, complications rate and changes in the vaginal axis before and after LLS by magnetic resonance imaging (MRI). Results: The anatomical success rate was 98.97% for apical prolapse and 85.57% for anterior prolapse, with a perioperative complication rate of 3.09% in the two-year follow-up. Mesh exposure at the vaginal cuff was observed in five patients (5.15%), all of whom had a concomitant hysterectomy. The patient satisfactory rate (evaluated by PGI-I score ≤3) was 96.67% at 24 months postoperatively. On MRI, no significant differences were observed between the Post-LLS and nulliparous women regarding the angle between the lower and upper vagina or the Cx/Apical line at rest (p> 0.05). Conclusion: LLS is an effective and safe surgical technique for treatment of apical prolapse with or without anterior prolapse, demonstrating low complication rates and high anatomic curative rates in short-term follow-up. MRI examination showed that a level-Ⅰ defect can be effectively addressed well through LLS, highlighting its capability to restore apical support.