Objectives To study the outcome of various hysterectomies in 2 years 1996 (N =10110) and 2006 (N=5279). The hypothesis was that the change in operative practices in 10 years has resulted in improvements. Design 2 prospective nationwide cohort evaluations with the same questionnaire. Setting All national operative hospitals in Finland. Participants Patients scheduled to either abdominal hysterectomy (AH), vaginal hysterectomy (VH) or laparoscopic hysterectomy (LH) for benign disease. Outcome measures Patients’ characteristics, surgery-related details and complications (organ injury, infection, venous thromboembolism and haemorrhage). Results The overall complication rates fell in LH and markedly in VH (from 22.2% to 11.7%, p