Objectives: To correlate indications of hysterectomy with the histopathological findings, in order to determine the percentage of preoperative diagnosis that was confirmed on histopathology and to determine the frequency of unexpected pathologies. Methods: A retrospective study of 200 patients who had elective hysterectomy performed for various indications during the study period from January 2014 to December 2014 was conducted. Settings: Karpaga Vinayaga Institute of Medical Sciences and Research Institute. Results: 97.5% of hysterectomies were done for benign indications. The most common pathology identified was Leiomyoma in 32% of cases. Hysterectomies done for UV prolapse showed atrophic endometrium in 62.7% of cases. Other less frequent pathologies identified included endometrial hyperplasia, disordered proliferative phase and endometrial polyps. Conclusion: Histopathological analysis correlated well with preoperative clinical diagnosis for hysterectomy. Benign pathologies were more common than their malignant counterparts. The commonest indication and histological finding in our setting was leiomyoma. The clinical and pathological correlation is 91.8% in case of leiomyoma. Histological diagnosis is considered the definitive method of evaluating tumours.