Background: Ablation of the endometrial lining of the uterus as an alternative to hysterectomy was found to be a less invasive and aggressive method. A large number of clinical trials, as well as retrospective analysis of clinical and financial data, has shown that endometrial ablation allows for a lower morbidity and mortality rate and significantly lower procedure costs. Worldwide, endometrial ablation is increasingly being adopted by the gynecological community. Objective: To study the effect of bipolar radiofrequency ablation system on endometrial thickness and bleeding in patients with premenopausal bleeding. Patients and Methods: This was a prospective comparative randomized study including 30 women with premenopausal bleeding not responding to medical treatment performed at Al-Azhar University hospitals and Gamal Abdel Nasser Hospital during the period from April 2016 to October 2018. Results: The majority of the patients improved (83.3%), 19 of them have complete recovery (63.3%), while 6 cases (20.0%) have minor bleeding, 4 cases (13.3%) have bleeding less before treatment, while only one case has no change. Conclusion: Bipolar radiofrequency ablation performed under local anaesthetic in the postmenstrual phase is an effective and efficient method of treating the majority of women who wish conservative surgical treatment for heavy menstrual loss.