Background and objective: Dilation and curettage (D&C) is commonly performed for the diagnosis of gynecological conditions leading to excessive uterine bleeding. The aim of this study was to evaluate different methods of curetting orientation to optimise the diagnosis of common pathological lesions associated with excessive uterine bleeding. Methods: Data and cases retrieved from women presented with excessive uterine bleeding and underwent D&C, at a private histopathology laboratory in Erbil city, Kurdistan region, from December 2010 to January 2012. Three methods of curetting orientation were carried out on 275 patients. Light microscopical study was done to asses the cause of excessive uterine bleeding. Results: A total of 274 out of 275 cases were found to have optimal tissue processing, embedding and histological examination. When the tissue specimens attached to filter paper and gauze, two out of 275 cases were found to have endometrial adenocarcinoma. Moreover, out of 275 cases, 198 were found to have dysfunctional uterine bleeding (hormonal imbalance) and 25 cases were found to have endometrial hyperplasia. Conclusion: Optimal tissue processing, embedding and histological orientation can be attained by using filter paper and/or gauze. Dilation and curettage is an adequate diagnostic tool for endometrial hyperplasia and carcinoma.