<b>Objectives:</b> Insurance status can be a proxy for social determinants of health and has been shown to correlate with poorer postoperative and oncologic outcomes. We sought to evaluate the relationship between insurance status and clinical outcomes among patients undergoing minimally invasive hysterectomy (MIS-H) by gynecologic oncologists at a single institution. <b>Methods:</b> We conducted an IRB-approved retrospective chart review of patients who underwent MIS-H by a gynecologic oncologist for benign or malignant pathology from January 2015 to December 2017. Insurance status (private or public), demographics, comorbidity information, surgical outcomes, and 3-year overall survival (OS) were collected and analyzed. Non-parametric tests and multivariate logistic regression were used to evaluate associations. <b>Results:</b> MIS-H was performed in 202 women, with 125 (61.9%) having private insurance and 77 (38.1%) having only public insurance (Medicare, Medicaid, or self-pay). Demographic characteristics are summarized in Table 1. Publicly insured patients were older (median 67 vs 52, p=<0.001), predominantly menopausal (79.2% vs 45.6%, p=<0.001), multiparous (3.9% nulliparous vs 17.7%, p=0.004), less likely to be White (85.7% vs 93.6%, p=0.009), and less likely to be married (46.8% vs 71.0%, p<0.001). Publicly insured patients also had significantly more comorbid conditions. They were more likely to have diabetes (32.5% vs 14.4%, p=0.004), COPD or asthma (19.5% vs 8.8%, p=0.032), hypertension (72.7% vs 38.2%, p=<0.001), hyperlipidemia (64.9% vs 25.0%, p=<0.001), and coronary artery disease (11.7% vs 2.4%, p=0.011). Surgical pathology was more likely to be benign in privately insured patients (57.3% vs 36.4%, p=0.006). Perioperative outcomes were evaluated with no significant difference in intraoperative complications (p=0.19), re-admissions (p=0.81), or subsequent surgeries related to the initial operation (including hernia surgeries or other elective procedures) (private 14.4%, public 5.2%, p=0.061). On univariate analysis of oncologic patients, only 104 privately insured patients had significantly more future operations (22% private vs 6% public, p=0.027). Further, among those with an oncologic diagnosis, there was no difference in OS (p=0.30). A multivariate analysis of future operations among the entire cohort controlled for potential confounders, such as age, adhesive disease, and intraabdominal disease. Insurance status was shown to be an independent risk factor for subsequent operation among the publicly insured (p=0.023). <b>Conclusions:</b> Publicly insured patients, as expected, were older and had increased comorbid conditions. Despite this, re-admission rates, operative times, and complications were not significantly different between populations. After controlling for confounders, insurance status was noted to be independently associated with subsequent surgical intervention, more frequent among the publicly insured. Further research may explore the possible differences that lead to increased reoperations among these patients.