Introduction: Hysterectomy is the second most common gynecological surgery next to caesarean section. The indications for hysterectomy may vary from one region to another and histomorphological pattern may also vary. Aim: The aim of the study is to analyze the various histomorphological patterns of uterine and adnexal pathology in the hysterectomy specimens. Material and Methods: This is a retrospective study done over a period of two years at the department of Pathology, Zoram Medical College, Mizoram. Data of all hysterectomy specimens during this period were analyzed. Results: Out of the 142 cases, Leiomyoma was the most common uterine pathology seen followed by adenomyosis, 63% and 13% respectively. Chronic cervicitis was the most common cervical pathology and, in the ovaries, tumor-like lesions functional cysts were the most common pathology seen. The most common indication for hysterectomy was fibroid followed by dysfunctional uterine bleeding. Conclusion: The histopathological findings correlate with the pre-operative clinical indications however, a number of lesions were incidental findings. Therefore, it is important that every hysterectomy specimen be subjected for histopathological examination for better post-operative management.