OBJECTIVES Hysterectomy is the most common procedure in gynaecology and carries a very high patient satisfaction rating by patients.  As a result, a number of economic benefits arise, including reduction in average length of stay (LOS), as well as readmission and surgical site infection rates using a minimally invasive route. The cost savings and efficiency gains accrued to the English NHS are presented in the form of a budget impact model. METHODS A budget impact model (BIM) was developed in order to compare the costs of two treatment strategies – total abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH). Micro-costing data was obtained from EKHUFT for a subset of TAH and TLH procedures. The latter was extrapolated at the National level using OPCS-level Hospital Episode Statistic (HES) in order to calculate cost and efficiency savings vis-à-vis average LOS and readmissions. This calculation relies on a conservative increase in laparoscopic adoption from 22 to 30%. RESULTS In 2013, 25,548 TAH procedures were carried out compared to 5,611 TLH. The LOS was 3.6 days for TAH compared to 1.3 days for TLH.  The readmission rates are significantly higher for TAH at 1.64/1000 procedures compared to 0.18/1000 for TLH. The estimated savings on increasing the TLH rate nationally by 8% will free 4000 patient days. On taking into account the lower readmission rate, lower LOS and potential income from additional procedures carried out from additional bed availability, the micro-costing of the procedure shows an overall financial benefit to the NHS.  CONCLUSIONS A increase in the laparoscopic approach to hysterectomy by 8% will result is significant economic benefits for the English health service. This study confirmed the reduced LOS, with a lower readmission rate following the laparoscopic approach. The budget impact of the calculated increase in costs of TLH can be absorbed within tariff.