One hundred four cesarean hysterectomies were done on the obstetric service of Louisiana State University School of Medicine over a six-year period, for an incidence of 1/110 cesarean sections or 1/824 deliveries. We categorize the indications for both nonemergency and emergency cases and present the chief components of perioperative morbidity, with particular reference to intraoperative blood loss and postoperative infection. The mean operating time was 126 minutes, blood loss 1,200 ml, transfusion 1.65 units, and hospital stay after surgery seven days. The postoperative morbidity was 42.9%. Emergency patients had an increased blood loss, a higher transfusion rate, and an increase in intraoperative complications. We emphasize the need to develop and maintain the operative skills required by these challenging emergency cases.