Background: Surgical management of vaginal vault prolapse post hysterectomy has improved with the use of the recto suspension technique. The technique is also used for prolapsing of the posterior vaginal wall rectus sheath suspension was described as a quick procedure with low morbidity and a short hospital stay. Objective: This study was aimed to evaluate rectus sheath suspension used as a treatment for vaginal vault prolapse after total abdominal hysterectomy. Patients and Methods: This interrupted time series clinical trial estimated the value of rectus sheath suspension of vaginal vault which was done on 50 patients undergoing total abdominal hysterectomy, at the Department of Obstetrics and Gynecology, Al-Azhar University Hospitals, Damietta. Results: Follow-up in the first week showed that the number of cystorectocele decreased to 5 (10%). Also, in the 1^st month of follow-up; after three months post-operative it increases to 7 (14%) cases. We found a significant decrease in cystorectocele number from pre and postoperative and a slight increase from 1^st to 3^rd months Conclusion: Using autogenous rectus fascia strips for suspention of vaginal vault in total abdominal hysterectomy is effective method for prophylaxis against vault prolapse after total abdominal hysterectomy and decrease number of postoperative cystorectocele in patients with preoperative mild cystorectocele, it also devoid of any serious complications such as described with other techniques.