A variety of procedures are available for the treatment of rectal prolapse. Perineal plication of a rectal prolapse, usually known as the Delorme procedure, has gained in popularity, particularly for elderly high-risk patients with multiple comorbid medical conditions. The procedure is performed without the need to resect bowel and is usually associated with no mortality, minimal morbidity, and moderately low recurrence rates. The Delorme procedure typically is not described in combination with pelvic floor repair. This video uses a combination of surgical diagrams and intraoperative video to demonstrate a step-by-step approach to performing a Delorme procedure in combination with pelvic floor repair or posterior levatorplasty. The anatomy and surgical technique are discussed in detail.