OBJECTIVE This paper examines the evidence about the impact of hysterectomy on one aspect of quality of life, sexuality. METHODS A systematic review of the French and English language literature was conducted using the search terms "sexuality", "hysterectomy", "libido", and "orgasm". RESULTS Twenty-one studies were found, ten prospective and 11 retrospective. Outcome measures were mostly postoperative libido and orgasm. Most studies did not consider important confounding factors. The majority of authors found either no change or an enhancement of sexuality in women who had an hysterectomy. CONCLUSIONS The majority of research evaluating the effect of hysterectomy on sexuality was poorly designed. The available evidence shows that hysterectomy did not adversely affect sexuality. A number of confounding factors should be taken into account in future studies. The role of the gynecologist in the preparation to this kind of operations is very important.