Approximately 500,000 hysterectomies are performed each year in the United States despite the existence of numerous nondefinitive alternatives. Gaining an understanding of the relationship between quality, safety, and cost is critical to gynecologists performing this procedure. Analysis of quality measures includes important process measures such as time-out procedures, the Surgical Care Improvement Project, Peer Review, and Credentialing. Databases, such as the National Surgical Quality Improvement Program, are also available for review of quality. Safety is evaluated by analyzing outcomes including complications, route of procedure, and patient satisfaction. The cost of hysterectomy is impacted by continuous quality and safety improvements.