OBJECTIVE To identify those women who might benefit from oestrogen replacement after hysterectomy. METHODS Targeted health screening. METHODS Large group practice. METHODS All women aged under 50 who had had a hysterectomy. METHODS Concentration of follicle stimulating hormone, symptom profile, uptake of oestrogen replacement therapy. RESULTS 145 of 1953 women aged 32-49 had had a hysterectomy. 35 of the 41 with bilateral oophorectomy and 27 of 104 with one or more ovaries conserved were taking oestrogen replacement. 62 of the 68 who had ovaries conserved and were not taking oestrogen replacement attended for review, of whom 14 had a follicle stimulating hormone concentration > or = 20 IU/l. 16 of the 19 women identified as potentially able to benefit from oestrogen replacement started treatment and were still on treatment at six months of follow up. CONCLUSIONS Systematic review of women who had had a hysterectomy identified an important group who would potentially benefit from oestrogen replacement therapy.