Purpose: To compare transverse muscle cutting Maylard incision and the Pfannenstiel incision in hysterectomies for large uterus. Materials and Methods: Ninety-five patients who underwent hysterectomy for myomatous uteri, larger than 14 weeks of gestation were included in the study. Results: The average intraoperative blood loss was lower in the Maylard group compared to Pfannenstiel group (114.65 cc and 129.04 cc p < 0.001, respectively). The mean operative time was shorter in the Maylard group with 73.9 minutes comparing to the Pfannenstiel group with 81.9 minutes (p < 0.001). There were no differences in postoperative additional analgesic requirements and postoperative 24-hour VAS scores in two groups (p = 0.8 and p = 0.231, respectively). Conclusion: The Maylard incision may be preferred in the patients whose uterus is larger than 14 weeks. Maylard incision may provide better pelvic view and shorter operative time in these patients. Although blood loss during surgery was less in the Maylard group, the authors believe that this amount of difference is not clinically important.