Introduction: Postmenopausal bleeding (PMB) is a common and early symptom of cervical and endometrial cancer. Its early detection can improve the cure rate and reduces mortality. The aim of this study is to find out the prevalence of bleeding in postmenopausal women in the rural population, its clinical presentation, histopathology incidence of malignancy. Method and Material: A prospective study performed in Maharajah's Institute Of Medical Sciences, Vizianagaram, over 100 women. When women presented to the outpatient with the complaint of postmenopausal bleed were enrolled in the study. Patient's demographic data were collected, the pap and endometrial HPE were studied. Results: The histopathological analysis showed proliferative endometrium (17%), secretory endometrium (10%), and atrophic endometrium (12%), and simple hyperplasia (14%), complex hyperplasia with atypia (8%), endometrial polyp (4%) and cervical polyp in (3%). Squamous cell cervical carcinoma (9%), endocervicitis (13%) of the population, endometrial malignancy in (3%) and no opinion were given in (7%). Conclusion:Postmenopausal bleeding needs a complete history, clinical examination and investigations to detect the cases of malignancy at an earlier date. High-risk women like nulligravida, obesity, diabetes, has to be considered as a special case and extensively investigated to rule out malignancy.