Introduction: Hysterectomy is one of the most common surgeries performed for common gynaecological indications, but less frequently done for tumors of female genital tract. Abnormal uterine bleeding (AUB) is one of the most common indications for hysterectomy. Histopathology is essential to confirm these common causes, but also helps to identify rare causes and to rule out malignancy. This study aims to anaylse the age pattern, clinical indications, clinicopathological correlation of hysterectomy cases along with distribution, causes and histopathological pattern of endometrial lesions in AUB. Material and Methods: The present study is a retrospective study done at Trichy SRM medical college hospital with hysterectomies done between January 2018 to November 2019 been included in the study. Clinical and Histopathological details were recorded, analysed and compared. Results: Of the 826 cases, Total abdominal hysterectomy was the most common surgery. The age varied from 21 to 85 with fourth decade as the most common age. Fibroid uterus and AUB were the most common clinical indication. Histopathology revealed leiomyoma as the most common diagnosis. About 95.5% cases correlated with clinical diagnosis. Of the 258 AUB cases, 100 had pure endometrial pathology and 31 cases showed combined endometrial and other pathologies. Totally 76 cases of endometrial hyperplasia were identified and 65 presented with AUB. About 11.6% AUB patients had malignancy and endometrial carcinomacomprised of 3.9% cases. Conclusion: Histopathological evaluation is essential to substantiate the clinical findings, identify missed pathologies, establishing a definitive etiology thereby aiding effective treatment of the pathology.