Aim: Hysteroscopic evaluation of women with postmenopausal bleeding with thickened endometrium. Material and methods: 100 patients were included in this study. Hysteroscopies was performed by vaginoscopic approach: with speculum, with adequate anesthesia, and with a 3- or 5-mm hysteroscope (30 degree view ). Isotonic sodium chloride was used as distension medium with a pressure of 50-70mmHg and flow (100- 120ml/min). Hysteroscopic examination included inspection of the uterine cavity with a panoramic shot, visualization of both tubal ostia, and observation of the cervical canal by removing the hysteroscope. Histological findings were classified as normal, if they were atrophic and as abnormal in cases of endometrial polyps, submucous myomas, endometritis, adenomyosis ,endometrial hyperplasia , endometrial cancer. Results: Sensitivity 89.6% vs 95.3%, specificity 87.3% vs 94.7%, positive predictive value 74.2% vs 93.18% and negative predictive value 95.3% vs 96.42% for ultrasonography+ histopathology and hysteroscopy respectively. Conclusion: We concluded that the hysteroscopy plays a valuable role in the assessment of postmenopausal bleeding, particularly in the identification of polyps.