The authors present a series of 556 vaginal hysterectomies carried out between the 1st October 1970 and the 30th September 1979. In the same period they carried out 338 abdominal hysterectomies. The main complication of using the vaginal route consists of the higher incidence of post-operative sepsis. But it is possible to prevent this. The vaginal route, on the other hand has the obvious advantages of speed of operation, less operative trauma, and above all lowering of the risk of thrombo-embolic disease (0.3 per cent as against 1.7 per cent in other reported series).