To present the clinical and radiological findings of cases evaluated by magnetic resonance (MR) defecography; to evaluate the relationship between pelvic floor prolapsus (PFP), spastic pelvic floor syndrome (SPFS) and thicknesses of fat tissue and puborectal muscles. MR defecograms of the patients evaluated between September 2015 and September 2017 were investigated retrospectively. PFP, involved compartment, severity of PFP (minimal, moderate, advanced), rectocele, invagination, enterocele and spastic pelvic floor syndrome; thickness of suprapubic, presacral, and pre-rectus abdominus fat tissues, right and left puborectal muscle thicknesses were measured. The correlations among PFP subgroups (anterior, middle, posterior); the relationship between the severity of PFP, and thickness of suprapubic, presacral and pre-rectus abdominus fat tissue was analyzed by Spearman’s correlation test. In the groups with and without spastic pelvic floor syndrome, thickness of suprapubic, presacral, and pre-rectus abdominus fat tissue and thickness of right-left puborectal muscle were compared by T-test. Of the 63 cases (mean age 45, 49 female, 14 male), 62 posterior, 35 middle, and 36 anterior compartment prolapses; 55 rectoceles, 28 invaginations, 3 enteroceles, 1 hypermobile urethra and 19 cases of SPFS were detected. There was a strong correlation between the middle and the anterior compartment prolapsus. There was a statistically significant correlation between middle compartment and rectus abdominalis anterior fat tissue thickness and between anterior compartment and rectus abdominus anterior fat tissue thickness. In addition, the suprapubic fat tissue in the SPFS group was thinner. The strong correlation between the middle and anterior compartment prolapses can indicate that the anterior compartment is easily affected when middle compartment is involved. The increase in fat tissue thickness may indicate that obesity may play a role in the etiology of middle and anterior compartment prolapsus, but it can be interpreted that the effect of obesity on the posterior compartment prolapsus and SPFS is not so apparent.