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Introduction: More than 80% of patients with full-thickness rectal prolapse have co-existing fecal incontinence. Choosing the ideal surgical strategy is always a difficult task. We combined an Altemeier rectosigmoid resection with anal dynamic graciloplasty to provide a functional neosphincter. We found no published reports describing this surgical association., Case Presentation: We report the case of a 72-year-old Caucasian woman with full-thickness rectal prolapse associated with fecal incontinence from severe neuromuscular damage., Conclusion: Combined dynamic graciloplasty and an Altemeier operation could be a valid therapeutic option in patients with severe rectal prolapse with fecal incontinence from severe neurogenic damage.