Numerous techniques for surgical creation of a neovagina have been described for treating Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Sigmoid vaginoplasty is one well-described technique with satisfactory long-term outcomes. However, there are several case reports of subsequent prolapse of the sigmoid neovagina, which presents a unique challenge for surgical repair, as the associated mesentery can also be involved and is at risk during repair. We present a patient with MRKH syndrome and recurrent sigmoid neovagina prolapse who had undergone four prior attempts at repair. In all prior attempts, recurrence of her prolapse occurred within 3 months of the antecedent surgery. We describe the first report and successful long-term treatment of recurrent sigmoid neovagina prolapse using a left-sided sacrospinous ligament suspension.