Background: Hysterectomy, widely performed for benign gynecologic conditions, is increasingly done laparoscopically due to reduced pain, quicker recovery, and lower blood loss. Recommended by AAGL and ACOG, laparoscopic hysterectomy requires advanced skills, especially for large uteri, with innovations like uterine morcellation enhancing feasibility while improving surgical precision and patient outcomes. Aim of the study: This study aims to evaluate the perioperative outcomes of laparoscopic hysterectomy for large uteri in a tertiary care hospital. Methods: This retrospective cohort study at the Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and two private Hospitals in Dhaka, Bangladesh, from February 2019 to January 2023 analyzed 120 patients undergoing laparoscopic hysterectomy for large uteri (>300g). Patients aged 18+ with benign gynecological conditions were included, excluding those with malignancies, laparoscopic contraindications, or prior extensive abdominal surgeries. Comprehensive preoperative assessments were conducted. Surgeries followed standardized laparoscopic-assisted vaginal hysterectomy protocols, addressing ovarian preservation/removal as needed. Intraoperative metrics included operating time and blood loss, while postoperative care emphasized early recovery and complication monitoring. Data were analyzed retrospectively, with outcomes reported as mean ± SD. Result: This study analyzed 100 women undergoing laparoscopic hysterectomy, with a mean age of 46.5 years and a BMI of 23.3 kg/m². Most participants (58.3%) were parous, with a mean uterine weight of 585 grams. Uterine myoma (80%) was the leading preoperative diagnosis. The average operative time was 88.9 minutes, with 575.4 mL blood loss and a 1.5-day hospital stay. Hemoglobin drop averaged 1.7 g/dL, and 17.5% required transfusions. Major complications, including bowel, bladder, or ureter injuries, were absent. Mild postoperative complications affected a few patients, with no reoperations or wound infections, showcasing the procedure’s safety and efficacy. Conclusion: Laparoscopic hysterectomy for large uteri proves safe and effective in tertiary care, offering minimal complications, reduced morbidity, and shorter hospital stays. While challenges, like increased operative time and blood loss, exist, the absence of major injuries or reoperations confirms its feasibility, showcasing the advantages of minimally invasive techniques in skilled hands.