Postmenopausal bleeding (PMB) accounts for 5% of all gynecologic office visits. PMB must always be investigated because many causes are premalignant or malignant.The current study is designed to determine whether endometrial volume or power Doppler indices as measured by 3D ultrasound imaging can discriminate between benign and malignant endometrium in women with postmenopausal bleeding and endometrial thickness ≥5mm.Material and methods: 53 cases, recruited from the outpatient gynecological clinic, Kasr El-Ainy Hospitals, were included in the study. All cases presented with postmenopausal bleeding were subjected to 3D transvaginal ultrasonographic evaluation of the endometrium, power Doppler ultrasound of the endometrium, 3D endometrial volume measurement and then dilatation and curettage (D&C) for the endometrium under general anesthesia after a written consent obtained and pathological examination of the specimens obtained. Results: In our study the mean age was 57.64 ±4.67 years, while the mean parity in our study was 2.45 ±1.35.In our study the most common endometrial histopathology was simple endometrial hyperplasia (38 cases; 71.7%) followed by complex endometrial hyperplasia (9 cases; 16.98 %) and (6 cases; 11.3%) of endometrial carcinoma.We found that both endometrial volume and 3D vascularization indices can discriminate between endometrial cancer and simple hyperplasia. However, histopathological diagnosis is always needed to confirm the suspicion.