Background: Endometrial cancer is currently the most common gynaecological malignancy in developed countries. The incidence of endometrial cancer is 3.7% to 17.9% in women with abnormal uterine bleeding. Most patients who have endometrial cancer present with postmenopausal uterine bleeding early in the development of the disease. Application of an appropriate and accurate diagnostic test in this situation usually results in early diagnosis, timely treatment, and a high cure rate Methods: A total of 60 postmenopausal women attending the outpatient and inpatient cases in Department of Obstetrics and Gynaecology of PESIMSR, Kuppam, AP from May 2017 to April 2019 were included for this study. All women were subjected to transvaginal ultrasonography to look for endometrial thickness and endometrial morphological characteristics and the same was compared to histopathology findings obtained by Pippel biopsy of endometrium. Results: The Mean endometrial thickness in atrophic endometrium was 3.86mm.The Mean endometrium in carcinoma endometrium was 21.29mm. Taking 4mm as cut off to define abnormal endometrium; this had a sensitivity of 85.71%, specificity of 62.50%, PPV of 66.66%, NPV of 83.33%. Conclusions:The reduction to three criteria in the diagnostic formula (with the simple rule: benign ifendometrial thickness is<4 mm, endometrial structure is homogeneous, and endometrial-myometrial border is regular; otherwise pathological) resulted in a useful sonmorphological differentiation of the endometrial findings and averts unnecessary invasive intervention like endometrial biopsy in women with benign cause of postmenopausal bleeding

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