Objective: To determine the role and significance of anatomy in the practice of obstetrics and gynaecology (O&G) and the relationship between the importance of anatomy and the acquisition of anatomical knowledge. Design: Explorative qualitative study. Setting: Belgium and the Netherlands. Population: Twelve gynaecologists and gynaecology trainees. Methods: Semi-structured Interviews including questions on the importance of anatomy in the practice of O&G. Main Outcome: Themes to understand the role of anatomy. Results: The role of anatomy in the practice of O&G lies in three areas: 1. daily activities 2. for the feeling of self-efficacy; 3. to gain a respected name as a doctor. Motivation plays a central role to which extent anatomy knowledge is actually obtained and seems to come quite late during postgraduate training or even while being already a gynaecologist. Stimulating factors for obtaining knowledge are responsibility, patient problems, new techniques and supervisors who pay attention to anatomy. Barriers are found in the feeling of insecurity and the lack of a reference. Conclusions: Although anatomical knowledge plays an important role in gynaecology practice, this importance is frequently not recognized until late in postgraduate training. This may have a negative impact on patient safety, as this late realisation can negatively affect knowledge acquisition. Trainees require reasons for action early in their curricula. Change in trainee motivations and innovations in teaching methods may optimise the process of knowledge acquisition. The overarching goal should be to educate doctors to work safely and with a high degree of self-efficacy.