Abnormal uterine bleeding is one of the commonest manifestations of thepremenopausal period. Although Dysfunctional bleeding is one of the important causes,yet endometrial focal lesions are considered one of the debilitating etiologies andcommon causes of failure of blind medical treatment.The aim of this study was to evaluate the role of each of 3D ultrasound, Dopplerstudies versus hysteroscopy and endometrial biopsy in comparison to each other, inscreening and detection of endometrial pathologies in premenopausal bleeding.Material and methods: 50 cases, recruited from the outpatient gynaecological clinic,Kasr El-Ainy Hospitals, were included in the study. All cases presented withpremenopausal bleeding. All patients were subjected to 3D transvaginalultrasonographic evaluation of the endometrium , Doppler velocimetric study of theuterine arteries , hysteroscopy and the results were correlated to the histopathologicalpicture of the endometrium.Results: The age ranged between 41 and 50 years with a mean of 45.7 years. Theyhad a mean parity of 3.7. The most common endometrial histopathology washyperplasia (26 cases , 52%) followed by disordered proliferative endometrium (14cases, 28%) then endometrial polyps (8 cases, 16 %) with 1 case of atrophicendometrium (2%) and 1 case of endometrial carcinoma (2%). Endometrial volumemeasurement and Uterine artery PI were significant investigations to differentiatebetween atrophic endometrium, benign endometrial pathology and endometrialcarcinoma in premenopausal patients but not a significant tools in differentiatinghyperplasia from polyp. Hysteroscopy is the best single investigation to use, to predictthe endometrial pathology. However, histopathologic diagnosis is always needed toconfirm the suspicion.