Background: A woman is considered menopausal after cessation of menstruation for one year. The goal of evaluations of postmenopausal bleeding (PMB) is to achieve the diagnosis with greatest accuracy, the least risk and expense for the patient. Transvaginal ultrasound (TVS) is imaging technique of choice for first line investigation of endometrial abnormalities as a possible cause of abnormal uterine bleeding, malignant and benign endometrial patterns can often be determined by TVS which can help diagnosis. Objectives: This study aims to assess the accuracy of endometrial volume and vascularization index assessed by three-dimensional ultrasound in prediction of endometrial carcinoma in woman with postmenopausal bleeding. Patients and Methods: This study was conducted in Ghamra Military Hospital on 100 women with postmenopausal bleeding. Results: Our results revealed that both endometrial thickness, volume, and 3D-PDA indices may discriminate between endometrial cancer and benign conditions in women with postmenopausal bleeding. All parameters of our study were not significant in diagnosis of cancer in women with postmenopausal bleeding. Conclusion: The diagnostic performance of the measurement of the size of the endometrium by three-dimensional ultrasound with respect to the distinction between benign and malignant endometriosis was higher when compared to the measurement of the thickness of the endometrium with 2D ultrasound.The Doppler flow indicators have three-dimensional power as good diagnostic tools in predicting endometrial cancer But it cannot rule out the presence of malignant tumors endometriosis.