Purpose: The literature validates Laparoscopic Ventral Mesh Rectopexy (LVMR) for External Rectal Prolapse (ERP), however limited studies report on patient outcomes following LVMR for Internal Rectal Prolapse (IRP). This study assessed patient outcomes following LVMR for IRP. Methodology: A 10-year (2014-2024) retrospective cohort study was conducted on patients who underwent LVMR for IRP at a specialist pelvic floor centre. Primary endpoints assessed the incidence of recurrent IRP and prevalence of persistent symptoms (poor outcome). Secondary endpoints assessed clinical and operative risk factors that may contribute to a poor outcome (PO) versus a satisfactory outcome (SO). Results: Included were 80 patients (30 SO versus 50 PO) with a median age of 62 years. The majority were female (98%). Median follow-up was 17 months. Six patients (8%) had recurrent IRP with 83% undergoing surgery for symptomatic palpable or radiologically confirmed IRP. Two patients (3%) developed ERP. Persistent symptoms occurred in 63% of patients. There were no significant differences observed in the outcome groups for patient demographics (age and body mass index), preoperative symptom severity and quality of life scores, or operative technique (Douglasectomy, number of rectal sutures, sacral fixation method and colpopexy). There were significantly higher rates of anterior and middle compartment prolapse surgery in the SO versus PO group (33% versus 26%, p = 0.001). Other clinical factors, including previous rectal prolapse surgery, connective tissue disorders and anal sphincter injuries were non-significant. Conclusion: Persistent symptoms frequently occur following LVMR for IRP with a large proportion of patients requiring further surgery.