The most common indication for emergency peripartum hysterectomy is severe uterine hemorrhage, which cannot be controlled by conservative measures. Such hemorrhage may be due to abnormal placentation (eg, placenta praevia and placenta praevia accreta), uterine atony, uterine rupture, leiomyomas, coagulopathy, over distension of the uterus (multiple pregnancy, polyhdramnios), or laceration of the uterine vessel(s), which is not treatable by conservative measures. The relative frequency of these conditions varies among series, and is dependent upon the patient’s population and practice patterns. Emergency peripartum hysterectomy is a life saving surgical procedure, which is usually carried out for postpartum haemorrhage, after a sequence of interventions are not successful. Advent of newer medical /conservative surgical methods of controlling postpartum haemorrhage, have reduced the incidence and indications of emergency peripartum hysterectomy. Sophistication in obstetric care and blood transfusion services has improved the outcome, especially in developed countries.