Elective bilateral salpingo-oophorectomy (BSO) is routinely offered to women undergoing hysterectomy for benign conditions to prevent subsequent ovarian cancer. However, the practice of BSO is controversial owing to conflicting literature on long-term consequences for cardiovascular disease, bone health, and total mortality. Jacoby et al used longitudinal data from 25 448 menopausal women enrolled in the Women's Health Initiative Observational Study with a history of hysterectomy and BSO (56%) or hysterectomy with ovarian conservation to examine differences in incident cardiovascular events, hip fracture, cancer, and death between groups. In multivariable analysis, BSO was not associated with an increased risk of fatal and nonfatal coronary heart disease, coronary artery bypass graft/percutaneous transluminal coronary angioplasty, stroke, total cardiovascular disease, hip fracture, or death. BSO decreased incident ovarian cancer, but ovarian cancer was rare in both groups. There were no significant associations for BSO and breast, colorectal, or lung cancer.