Introduction and hypothesis: The effect of a Pelvicol® graft compared with a conventional anterior vaginal repair was evaluated in this randomised controlled study. Methods: Only patients with a stage II or higher (Ba≥-1) defect were included. Results: Thirty-one patients were allocated to a conventional anterior repair; 30 to Pelvicol® graft. At 12 months follow-up, four patients among controls (15%) and two in the graft group (7%) had objective recurrence. Among controls, the difference at 3 months follow-up in Ba was 6.0 cm when compared with the position of Ba prior to surgery. In the graft group, the difference was 7.0 cm (P<0.05). This difference was still present at 12 months follow-up (6.0 vs. 7.0 cm; P<0.05). Conclusions: The implantation of a Pelvicol® graft does not improve the POP-Q stage.