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Laparoscopically assisted vaginal hysterectomy (LAVH) was compared to total abdominal hysterectomy (TAH). One hundred and six cases of LAVH were compared to 106 cases of TAH performed during the same time period. The cases were matched for weight and uterine weight. LAVH procedures were associated with increased operating room (OR) time (146.0 +/- 3.4 vs 61.9 +/- 2.3 min), decreased length of postoperative stay (3.5 +/- 0.14 vs 6.4 +/- 0.18 days) and decreased total narcotic use (527 +/- 40 vs 983 +/- 74 mg meperidine) compared to the TAH group. There was no difference in the complication rate between the two groups. Procedure costs were $4073.78 for the LAVH group and $4699.61 for the TAH group. LAVH is an alternative to TAH and has an acceptable complication rate.