Rectal prolapse in adults seriously affects the quality of life of patients with complex etiology, and surgery is still the main means of treatment for this disease. There are more specific surgical procedures, and the main surgical modalities are transperineal surgery, transabdominal surgery and transabdominal laparoscopic surgery. There is still no valid data to evaluate the effectiveness and indications of various surgical procedures, and the most ideal treatment method is still controversial. How to further improve the efficacy of surgery, restore good defecation function, reduce recurrence rate and complications is the current concern. Individualization of treatment methods may lead to the best treatment results. The choice of surgical approach for rectal prolapse is largely dependent on the clinical characteristics of the patient and the experience of the surgeon. Preoperative evaluation should include their anatomical defects, the cause and extent of prolapse, consideration of comorbidities, symptoms and anorectal function evaluation, and the overall status of the patient to determine suitability for surgery and to determine the best route and specific surgical approach for surgery. Although data from available studies are limited, patients should be evaluated preoperatively for at least postoperative complications, postoperative bowel function such as constipation, fecal incontinence, and postoperative recurrence. With systematic perioperative functional evaluation and regular individualized surgical treatment of patients with rectal prolapse, patients may have a desirable outcome.