Aim: The study aimed to analyze the clinicopathological profile, surgical practices, and survival outcomes of the patients with uterine sarcoma in eastern India. Background: Uterine sarcomas are a rare entity among gynecological malignancies with a very unfavorable prognosis. Due to its rarity, there is no consensus on a standardized treatment approach. Materials and methods: A retrospective analysis of all patients with a histopathological diagnosis of uterine sarcomas who were treated in our institute from 2012 to 2016 was done. The clinical parameters, treatment given, histopathological report, stage, and follow-up details of all patients were reviewed. Survival analysis was done using Kaplan–Meier method. Results: From 2012 to 2016, 40 patients with a diagnosis of uterine sarcoma were recorded. The median age of the patients was 44 years (range, 18–68 years). The youngest patient who got treated was an 18-year-old with low-grade endometrial stromal sarcoma (LGESS) with stage IIIC disease. Majority of the patients presented with abnormal uterine bleeding (60%) followed by abdominal pain (30%). Low-grade endometrial stromal sarcoma (42%) was the most frequent histological subtype of uterine sarcoma encountered followed by leiomyosarcoma (LMS) (40%), adenosarcoma (AS) (7.5%), undifferentiated endometrial sarcoma (UES) (5%), high-grade endometrial stromal sarcoma (HGESS) (2.5%), and uterine smooth muscle tumor of uncertain malignant potential (STUMP) (2.5%). Majority of the patients were diagnosed at stage I (92.5%) and only 2.5% of patients had stage IIIC disease. The patients were followed up for a median duration of 15 (range, 4–180) months. The median survivals of the patients diagnosed with different histological subtypes were 32, 11, 4, 9.5, 26, and 42 months for LGESS, LMS, HGESS, UES, AS, and STUMP, respectively. Median disease-free survival (DFS) for the entire cohort of uterine sarcoma was 32 months, and median overall survival (OS) was 57 months. Conclusion: Uterine sarcoma, when diagnosed even at an early stage was associated with increased recurrence rate and mortality. Clinical significance: Due to its aggressive behavior, an early diagnosis and a multimodal treatment approach should be considered.