Background: Abdominal or vaginal, complete or subtotal laparoscopic assisted vaginal hysterectomy is the most common elective major operation in gynecology. The present study was conducted to compare vaginal hysterectomy and abdominal hysterectomy for enlarged uterus. Materials & Methods: 78 women with enlarged uteruswere divided into 2 groups of 39 each. Group I patients underwent total abdominal hysterectomy and group II patients underwent vaginal hysterectomy. In both groups, parameters such parity, uterine weight, uterine size, indication, blood loss, and contraindications were noted. Results: Indication blood loss was 200-300 ml in 14 and 18 and 300-500 ml in 25 and 21 patients respectively. Operative time was <1 hour in 30 and 28 and >1 hour in 9 and 11 patients respectively. Indication for hysterectomy was adenomyosis in 4 and 9, fibroids in 13 and 12, endometrial hyperplasia in 12 and 10 and endometrial polyp in 10 and 8 patients in group I and II respectively. The size of uterus was <12 weeks in 26 and 25, >12 weeks in 13 and 14 patients. Parity was Nuli-P1 was 4 and 6, P2-P4 in 26 and 27 and P5-P7 in 9 and 6 patients. The weight of was 100-150 grams in 15 and 13, 150-200 in 14 and 17 and 200-250 in 10 and 9 patients respectively. The difference was significant (P< 0.05). Complications were bowel injury in 3 and 5, ureteric injury was 1 and 2, urinary tract infection in 1 and 3 and re- laparotomyin 2 and 4 patients in group I and II respectively. The difference was non- significant (P> 0.05). Conclusion: Up to 14 weeks following appropriate case selection and the application of bulk reducing methods such as bisection, myomectomy, morcellation, and coring, a vaginal hysterectomy may be performed in instances with an enlarged uterus due to a benign ailment. A safe and efficient treatment for moderately enlarged uteri is vaginal hysterectomy.