This is a comparative study carried on 30 patients complaining of perimenopausal bleeding in the age group between 40-60 years old.Two dimensional u/s followed by hysteroscopy with directed biopsy followed by D&C and histopathological examination are done for each patient.From our study, office panoramic hysteroscopy with directed biopsy is as sensitive and accurate as D&C in diagnosis of causes of perimenopausal bleeding with overall accuracy 97.56%.The accuracy of panoramic hysteroscopy with directed biopsy in diagnosis of endometrial carcinoma is doubted and we need to increase the sample size of the study for more valid results.