The objective of this study was to determine whether uterine weight affects the surgical outcomes of robot-assisted total laparoscopic hysterectomy (RH) procedures. The design of this study is retrospective cohort study. The classification of the study design is level II-2 evidence. The study setting is the Henry Ford Health System's Community Teaching Hospitals. One-hundred and thirty-five patients underwent RH for benign indications at one of two hospitals between January1, 2008, and June 1, 2010. Interventions were scheduled RH without concomitant uro-gynecologic procedures as the intention to treat. Patient demographics, age, height, weight, estimated blood loss (EBL), procedure duration, uterine weight, pathology, length of hospital stay (LOS), and any complications were obtained from a detailed review of electronic medical records. Uterine weight ranged from 47 to 1,290g (<250g, n=87; 250-500g, n=28; >500g, n=18). Overall, uterine weight was highly correlated with procedure duration (r=.53, P<.001.). Median procedure duration increased from 150min for the <250g group, to 205min for the 250-500g group, and to 295min for the >500g group. Uterine weight was also moderately correlated with EBL (r=.30, P=.0005). Median EBL increased from 50ml for uteri <250g to 87.5ml for the 250-500g group, and 100ml for the >500g group. This correlation did not persist in the assessment of decrease in peri-operative hemoglobin (r=.09, P=.30). Ninety-one women had a LOS of 1day (67.4%), 31 women had a LOS of 2days (23%), and 13 women had a LOS of greater than 2days (9.6%). Uterine weight was not correlated with LOS (r=.14, P=.10) and was not associated with increased major or minor complications (WRS P=.79) re-admission (WRS P=.35), or blood transfusion (n=3). RH can be performed on patients with large uteri exceeding 500g without associated adverse outcomes. Although procedure duration is increased, there is no significant effect on EBL and no increase in the occurrence of complications or length of stay.