Objective- To correlate the assessment of pelvic organ prolapse between POP-Q score measured preoperatively with Valsalva manoeuvre and intraoperatively with mechanical traction. Design – Cross sectional Setting – Midnapore Medical College ,Midnapore , West Bengal , India Sample - Women attending gynaecology out patient department ( OPD) with symptomatic pelvic organ prolapse and planned for vaginal operative treatment between March 2019 to February 2020. Methods - Preoperative examination was done in OPD by POP-Q system with Valsalva manoeuvre and final examination was done under spinal anesthesia with mechanical traction. The correlation was done between pre and intraoperative measurements. Results: All intraoperative POP-Q measurements showed significant higher descent as compared with preoperative measurements (mean difference Aa 0.72cm, Ba 1.08cm, C 1.66cm, Ap 0.26cm,Bp 1.6cm, D 1.6cm, Gh 0.6cm,) except for Pb and Tvl. . Among all nine measurements the greatest difference between preoperative and intraoperative were observed for point C, D and Bp. Conclusion:Preoperative POP-Q score significantly differed when assessed intraoperatively under spinal anesthesia with traction. Patient should beinformed that the surgical plan might change depending on the intraoperative findings.Our study is an alert for both surgeon and patient.