Despite the development of treatment providing a potential alternative to hysterectomy, the incidence of hysterectomy does not appear to be declining. Hysterectomy is one of the most frequently performed gynecologic procedures, with approximately 600,000 women undergoing this procedure annually in the United States. This study was carried out to review the clinical indication for hysterectomy and postoperative histological finding and to assess the incidence of complications.Study designThis is a prospective study, 50 patients were invited to participate in the study that were already planned to undergo abdominal or vaginal hysterectomy for different elective indications in the OB/GYN department, Kasr Elaini Hospital, Faculty of Medicine, Cairo University during the period from April 2012 till August 2012.MethodsDetails of indications, histologic finding and pre and postoperative complications were reviewed and analyzed for 50 patients, who underwent hysterectomy at the gynecologic surgical unit of Al Kasr Alaini hospital.ResultsMost of hysterectomies were performed abdominally in 46(92 %), and vaginally 4 (8%). No laparoscopic hysterectomies were done during the study period. The most common indication was AUB 21(42%) followed by menorrahgia secondary to fibroid 15(30%).Ten, eight and six percent were found for fibroid, uterine prolapse, and abdominal mass respectively. Post-operative, the histologic findings in 21 patients with AUB were 15 SEH (71.4 %) and 6 adenomyosis (62%) and 6 (28.6%) with E polyp, in fibroid were 5 (100%) leiomyoma, 1(20%) adenomyosis .Uterine prolapse showed one patient with normal histological pattern and 3 (75%) showed SEH. Abdominal mass 2 (66.6%) showed adenomyosis and 1patient with E polyp and other SEH.The complications were fever, blood transfusions, bladder, ureteric injury and wound infection. All complications occurred in abdominal hysterectomy with no complications noted in the vaginal route.Conclusion: abdominal route was the most common method used in hysterectomy and was accompanied with more complications. Vaginal hysterectomy shouldn’t be exclusive for uterine prolapse and Laparoscopic hysterectomy should be introduced in Kasr El Aini hospital. Hysterectomies were done for 50% abnormal uterine bleeding which may be managed by less invasive and less costly methods such as endometrial ablation.