Background: Abnormal uterine bleeding (AUB) is a common condition that leads to increased health care costs and decreased quality of life. A systematic approach to AUB evaluation can simplify management and enhance women's well-being. Objective: Management of MRI in women with AUB to detect any organic cause not detected with transvaginal ultrasonographic examination and if MRI add any advantage more than transvaginal ultrasound. Patients and methods: Fifty women with abnormal uterine bleeding were referred from the outpatient clinic and inpatients of OB/GYN Department at Sohag University Hospital was subject for this study. Results: MRI results in the diagnosis of fibroid had a sensitivity and specificity of 100% and the 2D TVS had a sensitivity of 80% and specificity 100 %. The falsely positive MRI was focal type adenomyosis miss diagnosed as interstitial fibroid. The sensitivity of the MRI for the adenomyosis in our results was 100% with specificity was 95%. Our results of adenomyosis using 2D transvaginal ultrasound had sensitivity 80% and specificity 97.5%. Our results using MRI had a sensitivity of 100% in endometrial polyp detection with specificity 90.47%. TVS had a sensitivity of 50% with specificity 100%. Conclusion: Management of MRI in abnormal uterine bleeding as equal as that of TVS but still TVS has the upper hand as the first imaging choice, real time imaging. patients also preferred TVS than MRI.