Abstract: Background: The lifetime risk of hysterectomies ranges from 20% to 35%1-3. With the surge of medicolegal law suits, risk of premature surgical menopause after hysterectomy, surgical and anaesthetic risks involved and availability of alternative noninvasive management options, every effort should be made to avoid hysterectomy wherever possible. Clinico-pathological audit of hysterectomies can help us define and improve our standards of diagnosis and justification of the hysterectomies performed. Objective: To explore the pre-operative diagnosis, surgery performed and histopathological findings in Shaheed Tazuddin Ahmad Medical College & Hospital, Gazipur, Bangladesh. Methods: The Study was conducted in the department of obstetrics and gynaecology of Dhaka Medical College Hospital, Dhaka, Bangladesh to find out the common indications of hysterectomy. 100 cases were randomly selected for the study whose common indication of hysterectomy. Clinical examination and evaluation were done from October 2004 to February 2005. Other necessary investigations were done if clinically indicated and to prepare the patient for anesthesia. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: Majority of cases who underwent hysterectomy were 31-40 years (52%) of age. Out of 100 cases most of patients (70%) underwent abdominal hysterectomy and only 30 (30%) cases underwent vaginal hysterectomy. Out of 33 cases, clinically diagnosed as leiomyoma of the uterus histopathology revealed leiomyoma in 24 cases. In uncomplicated abdominal and vaginal hysterectomy, the duration of surgery was almost same, vaginal hysterectomies needs slightly longer time. Average hospital stay after operation was same. Conclusion: There were significantly fewer hysterectomies for malignancy and a higher rate of oophrectomies with hysterectomy in a tertiary care hospital.