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Vaginal bleeding is common in women with liver cirrhosis. Hysterectomy is frequently done in women with liver cirrhosis. However, the postoperative mortality and morbidity is high and is correlated with severity of liver disease and other factors. Nonsurgical conservative options such as hormonal therapy or endometrial ablation should be tried first in women with liver cirrhosis. If surgery is needed, minimally invasive approach should be always considered. Women with liver cirrhosis undergoing surgery need extensive work up and should be optimized during the perioperative period. Further, surgery should be performed by an experienced surgeon and in a tertiary center.