Background: The intrauterine contraceptive device (IUD) has been one of the most commonly used forms of contraception throughout the world over the last 50 years. This study aimed to determine the incidence of mal-positioned IUCD (located abnormally in the myometrium or in the cervix) in patients presenting with abnormal uterine bleeding by using 3D ultrasound in comparison with 2D ultrasound. Methods: This study was conducted on 100 patients who underwent gynecological 2D ultrasound. They had a 3D volume acquisition of the uterus in addition to the standard 2D ultrasound evaluation in cases with abnormal uterine bleeding. The coronal view of the uterus was then reconstructed to evaluate endometrial polyps and the position of fibroids, and to determine the configuration of the uterus. Results The mean age was 31.3± 2.85. The mean BMI was 27.4± 2.40. 85% of cases were displacement, 4.7% penetration, 9.4% malposition. There were 45.0% with Pelvic pain, 85.0 % with Abnormal Bleeding. There were 21.0% with Localization of IUD, 1.0% Suspected fibroid, 1.0% Suspected ovarian cyst. There were 79.0% by 2D mode, 96% by 3D mode. Regarding 3D and 2D mode in detection of malposition of the IUD. There were 95.0% by 3D mode, 77% 2D mode. As regard 3D mode in detection of malposition of the IUD, Sensitivity was 95.0%, Specificity was 90.0%, PPV was 90.47%, NPV was 94.7%. Conclusion: 3D ultrasound assessment followed has proven a higher accuracy when compared to the 2D technique in the visualization of IUDs and the diagnosis of mal-positioned IUDs.