This late-gestation, multiparous Holstein cow presented with a Grade I vaginal prolapse. The prolapse eventually progressed to a Grade IV with continuous eversion of the vagina and cervix and necrosis of the vaginal tissue. Although the cow calved normally, she was culled from the herd due to the likelihood of recurrence of the vaginal prolapse in her next pregnancy. (Grade IV prolapse = chronic prolapse of either grade II or III with resultant trauma, infection, or necrosis)