INTRODUCTION: Hysterectomy is one of the commonly performed surgeries by the gynecologists apart from caesarean section for various benign and malignant gynecological problems pertaining to uterus, tubes and ovaries. Two major routes commonly performed are abdominal and vaginal hysterectomy apart from laparoscopic hysterectomy. OBJECTIVE: The purpose of this study was to find out frequency, indications, complications of Total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH) done at Vinayaka Missions Medical College and Hospital, Karaikal and their impact on future. STUDY DESIGN: Historic cohort. MATERIALS AND METHODS: This is a retrospective study involving 1080 patients, 685 patients had TAH and 395 patients had VH between 2007 and 2012. The original case files and surgery reports were analyzed and data collected with reference to age, indication, parity, blood group, associated pelvic pathology and uterus size, comorbidity, previous surgery, pre and post-operative transfusions, type of anesthesia, intra operative and post-operative complications, duration of hospital stay and the course of antibiotics. RESULTS: From our study we found that the morbidity for abdominal hysterectomy was more compared to vaginal hysterectomy for benign diseases in various aspects except for intra-operative blood loss which was more for vaginal hysterectomy in comparison with abdominal hysterectomy. The average duration of indwelling catheter was less in VH compared to TAH. There was no significant difference in the outcome with the type of anesthesia and the course of antibiotics. CONCLUSION: The overall complications for VH in selected cases were lesser than TAH which may suggest that VH may be an appropriate alternative to TAH.