Introduction:In this era, as the life expectancy is increasing, women are experiencing a long postmenopausal phase. Postmenopausal bleeding (PMB) is a sinister complaint and accounts for about 10% of postmenopausal complaints. Being a symptom of varied etiologies and its strong association with malignancy, it should be diligently evaluated. Aims and Objectives: 1. To evaluate the histopathological spectrum of lesions presenting as PMB. 2. To estimate the incidence of premalignant, and malignant lesions presenting as PMB. 3. To confirm the benign nature of the lesions to prevent unnecessary radical treatment. Materials and Methods: This prospective study done from January 2016 to September 2017 and included the endometrial biopsies/curettages and cervical biopsies sent for histopathological examination from clinically diagnosed cases of postmenopausal bleeding. Results: Out of all the samples majority were benign lesions (44%), followed by premalignant (25.7%), malignant lesions (18.3%). Conclusion: A variety of histopathological findings are seen in PMB. Benign pathologies were more common in our study but the collective proportion of premalignant and malignant lesions is considerably higher in this study. Accurate diagnosis makes it much easier to counsel the patient about further course of management, prevent unnecessary radical treatment for benign conditions, prompt treatment, and vigilant follow up for malignant lesions.