The surgical procedure of hysterectomy, which involves the removal of the uterus, is widely performed in the field of gynecology globally. However, the frequency of hysterectomies varies across countries and regions. The study aimed to determine the most frequent cause of abnormal uterine bleeding and the age group that undergoes hysterectomies most frequently by examining the histopathological results of hysterectomy specimens. A cross-sectional study was conducted at a tertiary care hospital in India, including 218 hysterectomy specimens received over a three-year period. The specimens were processed and examined histopathologically, and data on age, indication for hysterectomy, type of hysterectomy, and presence of co-existing gynecological pathology were collected and analyzed using SPSS software. The study found that the highest frequency of hysterectomy was observed in the age group of 40-49 years, accounting for 39.9% of all cases. The most common type of hysterectomy performed was Subtotal Hysterectomy / Supracervical Hysterectomy, which accounted for 34.4% of all cases. The most frequent cause of abnormal uterine bleeding was leiomyoma, accounting for 40.4% of all cases, followed by adenomyosis, which accounted for 22.5% of all cases. The study identifies abnormal uterine bleeding (AUB), predominantly due to leiomyoma, as the leading cause of hysterectomy among women aged 40-49 years. The findings emphasize the critical role of histopathological examination in all hysterectomy specimens to detect malignancies, regardless of preoperative assessments.