Aim: The aim of the present study is to evaluate the diagnostic value of blood flow measurements in spiral artery by transvaginal Colour Doppler Sonography (CDS) in predicting endometrial tumors. Material & Methods: A prospective observational study was carried out at Department of radiology and secondary data of patients is collected from the Obstetrics and Gynaecology department. 200 patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included. Results: Mean age, parity, and endometrial thickness of the participants were 45.15±2.58 years, 3.2 ± 2.14 and 12.46±6.34 mm respectively. The histopathological diagnoses were as follows; 84 cases (42%) endometrial polyp, 18 cases (8%) endometrial hyperplasia, 24 cases (12%) submucous myoma, 16 cases (8%) endometrium cancer, and 60 cases (30%) nonspecific findings. There were significant correlations between spiral artery PI and different endometrial histopathological pictures. There were significant correlations between spiral artery RI and different endometrial disease conditions (tumors). Conclusion: Endometrial spiral artery Doppler changes were strongly associated with the existing endometrial tumors and diseases among the study participants.