BACKGROUND: Hysterectomy is a major and common surgical procedure that has the potential to provide relief from ongoing gynaecological problems, but is often associated with negative impacts on health and wellbeing. Research indicates that hysterectomy rates and trends vary widely between and within countries; yet little is known about patterns in Australia. AIMS: This research aimed to describe hysterectomy rates and trends in Australia between 2000/01 and 2004/05. METHODS: This repeat cross-sectional study used routinely collected data from all hospitals in Australia. Data on all women admitted to hospital for a hysterectomy were obtained from the National Hospital Morbidity Database (2000/01-2004/05). Data were analysed by calculating population rates for each type of hysterectomy. Incidence rate ratios were calculated to assess changes over time. RESULTS: Hysterectomy rates in Australia declined from 34.8 per 10 000 women in 2000/01 to 31.2 per 10 000 women in 2004/05. A decline in the incidence rate for abdominal hysterectomy (from 18.7 to 15.1 per 10 000 women) and the incidence rate for concurrent oophorectomy (from 12.4 to 11.3 per 10 000 women) were also observed during this time period. At each point in time, the highest incidence rates for hysterectomy were for women aged 45-54 years. CONCLUSIONS: Hysterectomy rates in Australia are declining over time and currently appear to be lower than most other countries. More hysterectomies are performed vaginally than in Canada, the USA, the UK and Finland and the rate of concurrent oophorectomy is less than that reported in the USA and the UK.