Objective: The aim of this research was to determine the association between uterine weight and surgical outcomes of vaginal hysterectomies (VHs). Materials and Methods: This retrospective cohort study was conducted through a residency training program for performing VH operations (N = 87) in the Hacettepe University Hospital, Sihhiye/Ankara, Turkey. VHs performed for benign gynecologic conditions were included in the study. The patients were divided into 2 groups: (1) uterine weight <100 g and (2) uterine weight >= 100 g. Clinical characteristics, demographic features, surgical characteristics, and operative complications were compared between the groups. Results: There were 57 patients (65.5%) in group 1 (uterine weight <100 g) and 30 patients (34.5%) in group 2 (uterine weight >= 100 g). Mean uterine weights were 61.56 +/- 17.98 g in group 1 and 146.30 +/- 45.16 g in group 2. There was no statistically significant difference between the groups in terms of surgical procedures performed concomitantly. A statistically significant difference was found between the groups in terms of age (59.35 +/- 9.95 for group 1 and 47.37 +/- 3.64 for group 2; p < 0.001). In group 2, the following were statistically significantly higher: mean operation time (p < 0.001); delta Hb (p < 0.001); blood loss (p < 0.001); surgical complications (p < 0.005); mean total hospital stay (p < 0.001); analgesic needs (p < 0.001); blood transfusions (p < 0.02); and readmissions to the hospital (p < 0.001). Conclusions: All patients should be evaluated and scanned prior to VH to determine uterine size and weight in order to choose the best surgical approach.