Most of the women in our environment abhor hysterectomy but it remains the only option in most cases in our practice of gynaecology due to late presentation when it becomes more difficult to offer a less radical management options. This study aims to evaluate the indications, clinical characteristics and management outcome in the Niger Delta of Nigeria. This is a retrospective analysis of all Hysterectomies performed from 1st January, 2000 through 31st December, 2005 at the University of Port Harcourt Teaching Hospital. There were 170 cases of elective hysterectomy out of a total of 1025 elective major gynaecological surgeries during the study period with hysterectomy prevalence of 16.6%. The mean age of the patients was 46.5 years, 21(13.55%) of the women were nulliparous. The major indications were symptomatic uterine fibroid 55.5%, ovarian tumour 14.8% and uterovaginal prolapsed 8.4%. The surgery in 92 (59.4%) patients was performed by consultants. The crude morbidity and case fatality rates was 45.45% and 3.87% respectively. Elective hysterectomy for gynaecological condition remains a valid management option in our environment. The use of peri-operative antibiotics is advised to reduce the incidence of post-operative morbidity.