Abnormal uterine bleeding is a common gynaecological presentation in out patient clinic, but is often complex and difficult to diagnose. Whilst most patients have benign diseases, thorough investigation is necessary, particularly in the perimenopausal woman. A cross-sectional study was done among 50 patients between the ages 40 and 55 years. 2D TVS, hysteroscopy and histopathologic examination of tissue specimen were done in all the cases considering histopathologic report to be the gold standard, endometrial hyperplasia was the commonest finding. 2D TVS was more sensitive and accurate than hysteroscopy in differentiating normal fom diseased uterine cavity and in diagnosing endometrial hyperplasia while hysteroscopy show higher specificity.For detection of endometrial polyp hysteroscopy was highly sensitive, specific and accurate, for adenomyosis hysteroscopic accuracy was comparable to that of ultrasound but with poor sensitivity.