ABSTRACT Study objective: to gain an understanding of patient preferences regarding choice of surgical approach to hysterectomy. Design: Cross-sectional, analytical study. Setting: Tertiary hospital, referral center for gynecologic surgery in Medellin, Colombia Patients: A total of 300 women, 150 who were scheduled for hysterectomy and 150 women who were not undergoing any surgical procedure. Interventions: A questionnaire listing advantages of laparoscopic, vaginal, and abdominal hysterectomy was designed and applied to all participating women, who were then asked to rank in order of relevance the surveyed items. Answers and demographic variables were collected. Measurements and Main results: Average scores were calculated for each of the listed variables, and the difference of medians between groups (women scheduled to undergo hysterectomy and women who were not undergoing surgery) was analyzed. Difference of medians was also analyzed by grouping participants based on educational level. Participating women ranked as most important: safety, pain, duration of sick leave, scars, operative time, duration of surgical training, and cost. Altogether, women preferred advantages offered by laparoscopic hysterectomy over those provided by vaginal or abdominal approaches. Conclusion: Patient preferences should be taken into account upon deciding the surgical approach to hysterectomy, as they may differ from those of the physician. Key Words: Hysterectomy, preferences, approach