ObjectiveThe objective of this study was to establish a learning curve as represented by operative time for laparoscopically assisted vaginal hysterectomy (LAVH).MethodsOne hundred seventy-five consecutive laparoscopically assisted vaginal hysterectomies performed by four experienced gynecologists were reviewed retrospectively. Changes in operating times were analyzed by a Lowess (smoothed) plot.ResultsFor three of four physicians, operating time reached a plateau at 22 cases. No significant difference was observed with respect to preoperative diagnosis, patient weight, estimated blood loss, or uterine weight, before or after the plateau for any physician. Seven of the ten bladder injuries occurred before the plateau in operating time.ConclusionsFor LAVH, physicians experienced in vaginal surgery may expect to achieve the most efficient operating time by the 22nd case. As expected, more intraoperative complications occur early in the learning curve.