A suture-less pelvic implant system and method is provided for treating pelvic conditions, such as incontinence or vaginal prolapse. The implant can include a fixation portion, which may be rectangular or suture line, having a plurality of fixation elements, e.g., barbs, extending therefrom to fixate within target pelvic tissue, such as the vaginal apex. In a sacralcolpopexy, an opposing end or anchor of the implant is fixated within the sacrum or like structure to stabilize, raise, support or reposition the vaginal apex.