Objective: To determine surgical efficacy and outcome of hysterectomy combined with adnexectomy versus adnexectomy either unilateral or bilateral alone in treatment of postmenopausal women with low-risk ovarian cyst.Design: Prospective cohort study Setting: Mansoura University Hospitals Patients: 40 postmenopausal women with an ovarian cyst who underwent adnexectomy alone (either unilateral or bilateral) or hysterectomy combined with adnexectomy (either unilateral or bilateral) in the Department of Obstetrics and Gynecology, Mansoura University Hospital.Interventions: Patients were divided into two groups; Group 1 (n = 20) adnexectomy alone and group 2 (n = 20) adnexectomy combined with hysterectomy in a 1:1 ratioMeasurements and Main Results: There was a significant difference between both groups in the use of general anesthesia, operation time, need for blood transfusion, blood loss, mean change in hemoglobin and hematocrit before and after operation, frequency of postoperative complications, length of hospital stay, and postoperative Quality of life of patients, impairment   of sexual life, but no statistically significant difference between the studied groups in terms of pathology results.Conclusion: A statistical difference between both groups was found in intraoperative and postoperative complications, which were more common in the hysterectomy group, and sexual dysfunction was more common in this group than in the adnexectomy group. All of this made adnexectomy alone as effective as hysterectomy in treating postmenopausal ovarian cysts with low risk and much fewer complications.