Ｏｂｊｅｃｔｉｖｅ　Investigating the incidence and risk factors of postoperative ileus after hysterectomy for benign indications and the impact of postoperative ileus on surgical outcomes.　Methods　All patients who underwent hysterectomy for benign indications in Southern Hospital from January 1, 2013 to December 31, 2017 were included in this study. Patients who met the following criteria were deemed to experienced postoperative ileus: ① The signs of restoration of bowel function (passage of flatus or defecation) cannot be noted within 2 postoperative days. ② Symptoms of bowel dysfunction (nausea/vomiting or abdominal distention) were presented. Incidence and risk factors of postoperative ileus was investigated through statistical analysis. Surgical outcomes between patients with or without postoperative ileus were compared.　Results　A total of 1 017 cases were included in this study, including 432 laparotomy hysterectomy, 523 laparoscopic hysterectomy and 62 vaginal hysterectomy. Overall incidence of POI was 9.2%. Incidence of POI did not differ significantly in three different surgical approaches (abdominal hysterectomy 10.6%, laparoscopic hysterectomy 7.8%, vaginal hysterectomy 11.3%, P＞0.05). Patients who developed postoperative ileus had prolonged hospital stay and increased risk of postoperative complications. Independent risk factors identified by multivariate logistic regression included history of malignant disease, dysmenorrhea, way of anesthesia, pelvic adhesion and operative time.　Conclusions　Postoperative ileus causes undesirable consequences to post-surgical recovery. Identifying risk factors of postoperative ileus facilitates identifying high risk patients. Aggressive preventive strategy should be used on such patients to decrease the incidence of postoperative ileus.