Aim of the work: To compare the accuracy of both 2D-transvaginal ultrasound, saline sonohysterography and hysteroscopy in assessment of the uterine cavity in women with peri- and postmenopausal bleeding and their correlation with the histopathology. Also, to study the expression of endometrial estrogen and progesterone receptors in these women.Methods: 50 women with abnormal uterine bleeding (peri and postmenopausal) were subjected to transvaginal ultrasound, saline sonohysterography, diagnostic hysteroscopy and fractional curettage followed by histopathological examination of the specimens and immunohistochemical analysis for estrogen and progesterone receptors.Results and Conclusions: Measurement of endometrial thickness using ultrasound is of limited value. Sonohysterography is superior to ultrasound & very close to hysteroscopy, especially with intra-cavitary lesions. Hysteroscopy remains the gold standard for assessment of the uterine cavity, but can not replace the histopathology. The expression of endometrial steroid receptors plays an important role in the pathogenesis of endometrial polyps and endometrial hyperplasia.