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In 20 women after abdominal hysterectomy, a statistically significant increase of neopterin was observed. Because large amounts of neopterin are produced by macrophages upon stimulation with interferon-γ the data demonstrate significant cell -mediated immune activation in patients after surgery. Beginning from day 2-3 neopterin concentrations reach a plateau still remaining significantly higher than baseline even one week after operation. Peak neopterin values determined after hysterectomy inversely correlated with hemoglobin and hematocrit values measured on day 7 (rs = -0.606, p<0.005 ). The data show that abdominal hysterectomy is associated with activation of the cellular immune system .