Objective To assess the short‐term incidence of serious complications of surgery for urinary incontinence or pelvic organ prolapse. Design Prospective longitudinal cohort study using a surgical registry. Setting Thirteen public hospitals in France. Population A cohort of 1873 women undergoing surgery between February 2017 and August 2018. Methods Preliminary analysis of serious complications after a mean follow‐up of 7 months (0–18 months), according to type of surgery. Surgeons reported procedures and complications, which were verified by the hospitals’ information systems. Main outcome measures Serious complication requiring discontinuation of the procedure or subsequent surgical intervention, life‐threatening complication requiring resuscitation, or death. Results Fifty‐two women (2.8%, 95% CI 2.1–3.6%) experienced a serious complication either during surgery, requiring the discontinuation of the procedure, or during the first months of follow‐up, necessitating a subsequent reoperation. One woman also required resuscitation; no women died. Of 811 midurethral slings (MUSs), 11 were removed in part or totally (1.4%, 0.7–2.3%), as were two of 391 transvaginal meshes (0.5%, 0.1–1.6%), and four of 611 laparoscopically placed mesh implants (0.7%, 0.2–1.5%). The incidence of serious complications 6 months after the surgical procedure was estimated to be around 3.5% (2.0–5.0%) after MUS alone, 7.0% (2.8–11.3%) after MUS with prolapse surgery, 1.7% (0.0–3.8%) after vaginal native tissue repair, 2.8% (0.9–4.6%) after transvaginal mesh, and 1.0% (0.1–1.9%) after laparoscopy with mesh. Conclusions Early serious complications are relatively rare. Monitoring must be continued and expanded to assess the long‐term risk associated with mesh use and to identify its risk factors. Tweetable Short‐term serious complications are rare after surgery for urinary incontinence or pelvic organ prolapse, even with mesh. Tweetable Short‐term serious complications are rare after surgery for urinary incontinence or pelvic organ prolapse, even with mesh.