The successful treatment of vaginal vault prolapse with eversion continues to be an enigma to surgeons. The many surgical procedures that have been proposed testify to the fact that no single reliable procedure has been developed. The vaginal operation of posterior pelvic shelf colpopexy described in this report represents an evolution of ideas drawn from other surgeons coupled with the author's personal experience. The concept of creating a high, posterior pelvic shelf for vaginal vault fixation is developed, and the surgical technique is discussed in detail.