Study Objective The purpose of this study is to quantify preoperative blood typing and antibody screening (T&S), as well as blood transfusion rates for benign hysterectomies. We also aim to validate and adopt a model by Stanhiser et al. (2017) that predicts transfusion risk in gynecologic surgery. Lastly, we aim to assess the potential cost savings by decreasing T&S testing through application of this model. Design A retrospective cohort study utilizing the de-identified electronic medical record available at Vanderbilt University Medical Center's Synthetic Derivative Database. Setting Risk of transfusion in hysterectomy patients is low (0.3-11%), however T&S is often ordered routinely preoperatively. Identification of patient characteristics associated with risk of transfusion in gynecologic surgery enabled the development of transfusion risk prediction models. These models may help inform value-driven preoperative laboratory testing. Patients or Participants 5617 patients undergoing hysterectomies (vaginal, laparoscopic, robotic-assisted, or by laparotomy) for benign indications from 2000-2016 at a large academic, tertiary care medical center. Interventions N/A Measurements and Main Results A total of 5617 hysterectomies were identified, of which 1478 were performed by laparotomy. The blood transfusion rate was 4.7% (95% confidence interval [CI], 4.2-5.3%). Preoperative T&S was obtained for 53.4% (95% CI, 52.1-54.7%) of patients. Preliminary univariate validation confirmed that transfusion was positively associated with planned laparotomy, history of hypertension, and low hemoglobin (all P Conclusion Preoperative T&S testing occurred in more than half of benign hysterectomy patients, while the blood transfusion rate was 4.7%. There is potential for cost savings by decreasing the use of routine testing by adopting a validated transfusion risk prediction model. Future directions include continued model validation and cost calculations.