Local data regarding Manchester repair are not available in the current literature. We report a retrospective case series of 7 women who presented with uterine prolapse, and underwent Manchester repair from January 1997 to May 2008 at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. All of these women were multiparous (para 31) and wanted to avoid hysterectomy, and become pregnant. The duration of the procedure was 119 16 minutes. No operative complications were observed. The mean duration of follow up was 52 years. All of the women were satisfied with the procedure. Two (28.6%) patients subsequently became pregnant and had a successful vaginal delivery. Manchester repair is a valid alternative to hysterectomy for women with a second degree uterine prolapse who want to preserve their fertility.