Key PointsQuestionIs early hysterectomy before natural menopause in women associated with an increased risk of cardiovascular disease (CVD)?FindingsIn this Korean nationwide cohort study including 135 575 women, early surgical hysterectomy before age 50 years was independently associated with an increased risk of CVD, especially stroke. Even after excluding women who underwent oophorectomy, the hysterectomy group had higher risks of CVD than the nonhysterectomy group.MeaningThis study noted an association between early hysterectomy and an increased risk of CVD; because the incidence of CVD was not high, a change in clinical practice may not be needed.