We analyzed retrospectively the outcome of 15 patients treated with pelvic exenteration (nine total and six anterior) for gynecological cancer (six vaginal, four endometrial, three cervical, one vulvar, and one ovarian) from 1987 through 2008. Four operations were for primary tumors and 11 for recurrences. Eight patients had received prior radiotherapy. Median operation time was 310 (range 180-520) min, and median blood loss was 2,500 (range 600- 8,000) mL. Thirteen patients had altogether 59 postoperative complications, 25 (42%) early and 34 (58%) late. One patient each died of complications during the early and late postoperative phases, respectively. Both had received previous radiotherapy. By 31 January 2009, six patients had died, while five and four patients were alive with or without disease, respectively. Only one pelvic recurrence was found. The median progression-free survival was 8.9 months. Although pelvic exenteration was not totally devoid of mortality, the procedure provided a good local control, with mostly manageable complications.