Information is lacking from prospective studies on the incidence and risk factors for postoperative nerve injury after routine gynecologic surgery. In 2 retrospective studies, the reported risk of nerve injury from major gynecologic oncologic procedures was estimated to be between 1.1% and 1.9%. This prospective cohort study evaluated the overall incidence and time course of pelvic nerve injury in a population of 616 female patients undergoing elective gynecologic surgery for benign and malignant conditions. The study was conducted between 2007 and 2008 at a single academic medical center.