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Background and Purpose The purpose of this study was to determine whether pelvic organ prolapse severity, pelvic symptoms, quality of life, and sexual function differ based on pelvic-floor muscle function in women planning to have prolapse surgery. Subjects and Methods Three hundred seventeen women without urinary stress incontinence who were enrolled in a multicenter surgical trial were examined to determine pelvic-floor muscle function (by Brink scale score). The subjects were 61.6±10.2 (X±SD) years of age. Thirteen percent of the subjects had stage II (to the hymen) pelvic organ prolapse, 68% had stage III (beyond the hymen) prolapse, and 19% had stage IV (complete vaginal eversion) prolapse. Subjects with lowest (3-6) and highest (10-12) Brink scale scores were compared on prolapse severity, pelvic symptoms and bother, quality of life, and sexual function. Results Subjects with the highest Brink scores (n=75) had less advanced prolapse, smaller genital hiatus measurements, and less urinary symptom burden compared with those with the lowest Brink scores (n= 56). The results indicated that pelvic-floor muscle function was not associated with condition-specific quality of life or sexual function. Discussion and Conclusion Although modestly clinically significant, better pelvic-floor muscle function was associated with less severe prolapse and urinary symptoms., Pelvic organ prolapse is the descent of the apex of the vagina or cervix (or vaginal vault after hysterectomy), anterior vaginal wall (previously referred to as 'cystocele'), or posterior vaginal [...]