Objectives: This study was done as a comparative study of the accuracy of T.V.S. and office hysteroscopy in evaluation of the uterine cavity in cases of abnormal uterine bleeding in premenpausal period. Patients and methods: The study was included to 30 patients complaining of abnormal uterine bleeding in the age group between 36 -50 years old attending the gynaecology outpatient clinic in Kasr El-Aini Hospital, Cairo University in the period from February to August 2011. All patients were subjected to careful history, complete general, abdominal and vaginal examination and routine investigations. Then T.V.S. and office hysteroscopy was done. Results: 12 cases (40%) had a normal uterine cavity by T.V.S., 7 cases (23.3%) had fibroid, 5 cases (16.7%) had an endometrial polyp, 2 cases (6.7%) had cervical polyp, 3 cases (10%) adenomyosis and 2 cases hyperplasia. While by office hysteroscopy, 12 cases (40%) was normal, 5 cases (16.7%) had fibroid, 8 cases (26.7%) had endometrial polyp, 1 case had (3.3%) cervical polyp, 2 cases (6.7%) hyperplasia and 2 cases picture of endometrities. Conclusion: Office hysteroscopy offers an accurate method to investigate abnormal uterine bleeding and has an excellent guide for localization of pathology with high sensitivity and specificity in diagnosing polyp than T.V.S. while T.V.S. can be used as routine first step diagnostic technic.