Background: Total Abdominal Hysterectomy (TAH) is a common surgical procedure for treating various gynecological conditions. This study aims to evaluate the demographic characteristics, comorbidities, and clinical indications for TAH at Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh. Methods: This retrospective study included all TAH cases performed from January 2018 to August 2019. Data on patient age, comorbidities (hypertension and diabetes), and indications for TAH were collected from hospital records. Descriptive statistics were used to analyze the data. Results: A total of 320 TAH cases were reviewed. The most common age group was 41-50 years (43.13%), followed by patients aged ≤40 years (31.56%). Hypertension was present in 36.25% of the patients, and diabetes was observed in 30.94%. The most frequent indication for TAH was fibroid uterus (55.63%), followed by adenomyosis (18.75%) and post-menopausal bleeding (14.38%). Other indications included ovarian cysts (5.63%), endometrial hyperplasia (5.00%), and pelvic mass (6.25%). Conclusion: The findings highlight uterine fibroids, adenomyosis, and post-menopausal bleeding as the primary indications for TAH, with a significant prevalence of hypertension and diabetes among the patients. Effective management strategies for these conditions and considerations of comorbidities are crucial in optimizing surgical outcomes. Further research into minimally invasive techniques may enhance patient care in gynecological surgery.