Background: Hysterectomy is one of the most commonly performed surgeries worldwide. Indication for hysterectomy is most often benign, which includes conditions such as prolapse, abnormal uterine bleeding, fibroids and pelvic pain. Hysterectomy can be performed vaginally, abdominally or laparoscopically. Objective: The aim of work was to determine the frequency of use, evaluate and compare the most appropriate surgical method and assess the effectiveness and safety of the three approaches for hysterectomy: Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH) for women with benign gynecological conditions. Patients and Methods: This Prospective case control study was conducted on 75 women with benign disease of uterus with failed medical management or not amenable to medical management attending at Obstetrics and Gynecology Department, Al-Azhar University Hospitals. Patients were divided into three groups (25 cases each) for either technique of hysterectomy depending on the gynecological lesion that indicated the surgical procedure. Results: In the present study there was no statistically significant difference between the abdominal and laparoscopic groups as regard patients age, parity, BMI, previous CS, and previous pelvic surgeries. In our study fibroid represented the most common indication for abdominal hysterectomy (40%), vaginal hysterectomy (36 %) and Laparoscopic hysterectomy (48%). Conclusion: It could be concluded that laparoscopic hysterectomy has minimally invasive and is related to a low intra and postoperative complication rate, and even when there is a history of abdomino-pelvic surgery.