Aim and background: Over the past few decades, laparoscopic hysterectomies have dramatically increased and even exceed vaginal hysterectomies (VHs). This study aimed to determine which approach offers the greatest benefits based on the results of a total laparoscopic hysterectomy (TLH) and a laparoscopic-assisted vaginal hysterectomy (LAVH). Materials and methods: We performed a prospective study on patients posted for hysterectomy in the Department of Obstetrics and Gynecology from January 2021 to December 2021. An equal number of patients were posted for TLH and LAVH, according to the selection criteria, randomly, after getting written consent. The average age of the TLH group was 44 years and LAVH group was 46 years. Results: Among 100 patients, 50 patients were included in the LAVH group and 50 were included in the TLH group. A total of 30 patients were presented with previous lower abdominal pelvic surgery such as tubal ligation and appendectomy LSCS. The majority of patients who underwent TLH and LAVH were pathologically confirmed uterine fibroids (n = 36) and adenomyosis (n = 36). The LAVH required longer surgery duration (122.5 ± 25.37) than TLH (114.2 ± 18.93) with p = 0.066. In both groups, the average hospital stay was almost the same (4.26 vs 4) days. Conclusion: Total laparoscopic hysterectomy has an advantage over LAVH in terms of duration of surgery, blood loss, hospital stay, and postepisode recovery. Moreover, the decision to perform either LAVH or TLH should be based on the healthcare expertise in the field of laparoscopic and vaginal operative procedures. Also, patients’ satisfaction and mental health is a hallmark of surgeries. Clinical significance: Based on the present study, we recommended that TLH be an effective operative procedure as compared to LAVH. Because it requires a short duration for surgery, there is minimum blood loss, it does not require a prolonged hospital stay, and the patient's recovery time is also effective.