Introduction: Peripartum hysterectomy has to be done repeatedly as the last resort in saving a woman's existence. Currently, several drugs and surgical techniques have been established for the management of postpartum haemorrhages. The foremost indication for peripartum hysterectomy is severe uterine haemorrhage that cannot be controlled by conservative methods. Objectives: This study intended to find out the indication and frequency of peripartum hysterectomy in MAG Osmani Medical College Hospital, Sylhet. Methods: This prospective cross-sectional study on 100 cases of peripartum hysterectomy was carried out at the Department of Obstetrics & Gynaecology at Sylhet M.A.G Osmani Medical College Hospital, Sylhet from January 2004 to June 2005. Verbal consent was taken before recruiting the study population. Data was compiled and analysed manually. Result: The commonest age group involved in peripartum hysterectomy was 31-35 years (38,38.0%). The incidence of peripartum hysterectomy was 0.70%. Rupture uterus (76%) was the most common cause. Other causes are uterine atony (12%), Placenta praevia (2%), placenta accreta (2%) & sepsis in 6% of cases. Maximum patients (82,82.0%) did not get any antenatal care. Of those who got antenatal care, eighteen patients (18,18.0%) were irregularly booked. Conclusion: Emergency peripartum hysterectomy is a vital lifesaving technique and remains to have a high incidence in our community. The choice to implement an emergency peripartum hysterectomy is usually obscure as the obstetrician's paramount wish is to preserve the uterus for future childbearing.