Objectives: The advantages of trocar-less over trocar systems for pelvic organ prolapse (POP) repair with vaginal mesh are gained mainly by bypassing the need of blind trocar insertion, thus potentially reducing complications. The aims of the study were to evaluate the safety and efficacy of trocar-less system designed for POP repair. Materials and Methods: This is a retrospective, comparative study. One hundred-seven women were operated using the EndoFast ReliantTM, trocar-less system (study group), and 123 women underwent surgical POP repair with the IVS TUNNELLERTM (tyco healthcare) trocar system (control group). The patients were evaluated pre- and post-operatively including intra and post-operative complications, anatomical results using the POP quantification and questionnaires on functional symptoms. Results: Anatomical results were similar in both groups and there was significant improvement in all functional symptoms. There were significantly fewer complications in the study group, mainly intra-operative and immediate post-operative including: Significant bleeding (0.0% vs. 2.4%, p=0.1), bladder injury (0.0% vs. 2.4%, p=0.1), UTI and fever (2.8% vs 17.9%, p<0.001), hematomas (0.9% vs. 3.3%, p=0.23) and post-op voiding dysfunction and catheterization for more than 24 hours (0.9% vs. 13.8%, p<0.001). The surgical technique (Trocar-Less vs. Trocar System) was found as the only variable statistically significant with the correlation to early complications. Conclusion: The EndoFast ReliantTM system is a trocar-less system for treating POP. The operation has the potential for reducing intra- and post-operative complications, with very satisfactory functional and anatomical results. It was proven safer in this study as compared to trocar system.