Purpose: Laparoscopic techniques mimic open techniques but have had varying results. The current study evaluates recurrence rates and functional outcomes after laparoscopic approaches to the repair of full-thickness rectal prolapse. Methods: A retrospective chart review was performed on all patients with a laparoscopic procedure for full-thickness rectal prolapse from 1992-2002. A phone survey was carried out regarding patient satisfaction, bowel function and recurrence. Results: There were 47 laparoscopic attempted repairs, with 43 completed laparoscopically. Thirty-seven patients had resection and rectopexy, four had resection alone, and two patients had a laparoscopic mesh rectopexy. Overall recurrence rate was 28% (12/43) with a mean follow-up of 31(range 1-107) months. Three of four (75%) patients undergoing resection alone recurred. The recurrence rate was 23% (9/39) in patients treated with resection and rectopexy or rectopexy alone. Recurrences occurred from 1 to 67 months postoperatively with an average of 29 months. Six of nine patients undergoing resection and rectopexy or rectopexy alone recurred three years or later after surgery. Bowel function improved postoperatively in 75% of patients with diarrhea, 73% of patients with constipation and 71% of patients with fecal incontinence. Bowel function was worse postoperatively in 26% of patients with diarrhea, 16% of patients with constipation and 4% of patients with fecal incontinence. Conclusions: Laparoscopic resection alone carries a high recurrence rate and should be combined with a rectopexy to minimize the recurrence rate. Laparoscopic procedures may have a higher recurrence rate than open procedures with two-thirds of them occuring greater than three years after the initial procedure. Bowel function improved after laparoscopic correction of the rectal prolapse.