Background:Abnormal uterine bleeding (AUB) is overall the most common causes of gynecological visits in the perimenopausal and postmenopausal age, involving about 15% of women. Endometrial assessment has traditionally been achieved by obtaining tissue for histological analysis utilizing blind in-patient dilatation of the cervix and curettage of the endometrium under general anesthesia Diagnosis and treatment of endometrial pathology can nowadays benefit from well-established techniques, ranging from clinical examination to transvaginal ultrasound (TVS), 3D ultrasonography. The main aim of investigating women with abnormal uterine bleeding is to exclude serious intrauterine pathology, particularly endometrial cancer.Aim of workThis Study was to assess the potential value of volume measurements compared with that of endometrial thickness in differentiating between benign and malignant endometrial pathology in women with abnormal uterine bleeding.Patients and methods:This study included 40 patients complaining of perimenopausal and post-menopausal bleeding. All the selected patient had subjected to carefull history taking and then underwent general examination, local pelvic examination, 2D pelvic ultrasound, 3D endometrial volume measurement and then dilatation and curettage (D&C) or hystroscopic guided biopsy for focal endometrial or hysetrectomy . Inclusion criteria defined Post-menopausal bleeding, defined as lack of menstruation for _ 1year in women older than 45 years,Peri-menopausal bleeding defined as Age 40- 50 years Having any pattern of bleeding e.g., menorrhagia, metrorhagia, menometrorrhgia for more than 3 months and we must exclude any bleeding due to complication of pregnancy or any bleeding disorder.Results: The age ranged between 39 and 66 years with a mean of 50.15 ± 7.634 years. They had a mean parity of 1.13± 0.404.The most common bleeding pattern was postmenopausal bleeding. In the most common endometrial histopathology was simple endometrial hyperplasia. In our study there was no statistical significance relation between endometrial thickness and histopathology, the mean endometrial thickness was 11.7 ± 7.14mm. As regards the measurement of endometrial volume, in our study there was a high statistical significance relation between endometrial volume and histopathology, the mean endometrial volume was 6.3±6.2cc.Conclusion:The measurement of endometrial volume was superior to that of endometrial thickness as a diagnostic test for the detection of endometrial cancer in symptomatic perimenopausal and post-menopausal bleeding.