Background: Hysterectomy, a common surgical procedure for various gynecological conditions, significantly impacts women's health. This study aims to analyze the histopathological findings in hysterectomy specimens, correlating clinical indications with pathological outcomes, to enhance understanding, and improve patient management. Materials and methods: This retrospective observational study was conducted over 1 year (January 2023 to December 2023) at a tertiary care center. All hysterectomy specimens, irrespective of the surgical route or type, were included. Specimens were fixed in 10% formalin, processed, and stained using hematoxylin and eosin. Histopathological findings of the uterus, cervix, and ovaries were recorded and correlated with clinical diagnoses. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 29.0. Results: A total of 374 hysterectomies were performed: 70% abdominal, 26% vaginal, and 3% minimally invasive. Most patients (34.75%) were aged 41–50 years. Abnormal uterine bleeding (22.99%) and uterovaginal prolapse (20.85%) were the most common clinical indications. Histopathological examination revealed the proliferative phase of the endometrium (40.10%), leiomyomas in the myometrium (24.06%), and chronic cervicitis (23.52%) as the predominant findings. Gynecological malignancies accounted for 28.87% of cases, with ovarian cancer (13.36%) being the most frequent. Conclusion: Hysterectomy specimens commonly exhibit benign conditions such as proliferative endometrium, leiomyomas, and chronic cervicitis. Histopathological examination is crucial for confirming clinical diagnoses and guiding effective disease management. Clinical significance: This study underscores the importance of routine histopathological evaluation of hysterectomy specimens to ensure accurate diagnosis and optimal patient care. The findings highlight prevalent gynecological conditions, aiding clinicians in making informed decisions regarding hysterectomy indications and management.