The pelvic floor conditions form a diverse array of primarily functional conditions that are rarely life-threatening but may be severely debilitating. Reassurance combined with initial medical and dietary management of most of these conditions greatly ameliorates the suffering of most patients. Surgical intervention is most successful in patients with demonstrable defects such as mechanical sphincter disruption or obvious complete rectal prolapse. Surgery should be offered only to patients with other functional pelvic floor disorders who manifest intractable symptoms.