<h3>Introduction/Background</h3> Recent publications have shown that simple hysterectomy (SH) compared to radical hysterectomy (RH) might have similar survival outcomes for low-risk early-stage cervical cancer. This study aims to evaluate the overall survival of SH compared to RH in cervical cancer patients, including all tumors ≤2 cm. <h3>Methodology</h3> Using the National Cancer Database (NCDB), patients diagnosed with cervical squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma between 2004 and 2019 were included. This comprised all tumors ≤2 cm, categorized based on SH or RH performance with lymph node staging. Survival rates were assessed following 1:1 propensity score matching. A subgroup analysis was performed considering histology types, LVSI, surgical approach, utilization of chemotherapy and/or radiotherapy, lymph node involvement, and tumor size (1 cm cut-off). The primary objective was to analyze overall survival. Secondary objectives included evaluating the readmission rate within 30-days, and 30-day/90-day mortality rates. <h3>Results</h3> Among 8,047 patients, 2,856 (35.49%) underwent SH and 5,191 (64.51%) underwent RH. Following 1:1 propensity score matching, 2,856 patients were considered in each group. The median follow-up for SH and RH was 76.6 and 78 months, respectively. No overall survival difference was observed: HR 0.82 (95% CI 0.68 to 1, p = 0.05). The 5-year overall survival for SH and RH was 95% (95% CI 0.94–0.96) and 96% (95% CI 0.95–0.97), respectively; at 10-years was 89% (95% CI 0.88–0.91) and 91% (95% CI 0.89–0.92). No statistically significant differences were found in the sub-group analysis, readmission rate (p = 0.92), 30-day (p = 0.7), or 90-day mortality rate (p = 0.89). <h3>Conclusion</h3> This long-term follow-up analysis from a large cohort within the NCDB, showed that performing SH had no statistically significant differences in survival, compared to RH in early-stage cervical cancer patients with tumors less than 2 cm. No differences were found in readmission and mortality rates within the three months post-surgery. <h3>Disclosures</h3> No Disclosures.