The attitude of women to prophylactic hysterectomy (pH) after age 40 was investigated in 324 women in our out-patient clinic by a questionnaire taking into account psychological and sociological data. More than 50% of the women were against a prophylactic hysterectomy. This negative attitude cannot be explained by a desire for child bearing since only prophylactic hysterectomy after 40 was discussed. Other factors are important. The knowledge of the women about their reproductive organs was limited. One third of the patients thought the uterus is responsible for the production of sexual hormones and 3/4 of the women expected a hormonal imbalance following hysterectomy. The greater the ignorance the more frequent was the negative attitude to prophylactic hysterectomy (S 5%). 2/3 of the women ascribed a life long importance to the uterus and were against prophylactic hysterectomy (S 5%). 1/4 of the patients described the uterus as an organ important for sexual intercourse and therefore were against prophylactic hysterectomy (S 5%). It is understandable that 2/3 of the women thought of hysterectomy as a procedure which would have a negative or very negative influence on their lives (S 5%) when women ascribed to the uterus frequently a significance in hormone production or in sexuality in addition to the child bearing function of the uterus. Only approximately 1/3 of the women would feel of themselves as full women after a hysterectomy. Not quite 1/2 of the patients thought of the sterility following hysterectomy as a positive feeling and were more often accepting of the thought of a prophylactic hysterectomy (S 1%). Women who felt that they could talk about problems of their female genital organs with their partners had more often a negative attitude to prophylactic hysterectomy (S 1%). About 2/3 of the patients stated they would wish to have their partner present during a pre-operatitive discussion of a necessary hysterectomy. Only 1/4 of the patients were sure that a hysterectomy would not have a negative effect on their marital lives. Among the psychological factors, intelligence was of importance in the attitude to prophylactic hysterectomy. The more intelligent the woman, the more frequently she had a negative attitude to prophylactic hysterectomy (S 0.1%). There was no statistically significant correlation between personality factors according to Eysenck and the attitude to prophylactic hysterectomy. The older women more frequently accepted the thought of prophylactic hysterectomy (S 10%). The results were all tested statistically by the X2 method. A prophylactic hysterectomy should not be done without a thorough discussion of the attitudes and the expectational anxieties to such an operation.