BACKGROUND:Postmenopausal bleeding is a dreaded symptom both for the women and gynaecologist. Though it can be of benign origin, malignancy has to be ruled out and as such needs prompt evaluation. OBJECTIVE: (1) To study the etiological factors of postmenopausal bleeding and establish various endometrial causes of postmenopausal bleeding through histopathological evaluation. (2) To investigate the clinical significance of postmenopausal bleeding in terms of risk factors, incidence of malignancy and histopathological evaluation. METHODOLOGY: This observational study was conducted at Lalla Ded Hospital Srinagar over a period of 18 months in which 116 cases of postmenopausal bleeding were enrolled in the study. All patients were subjected to detailed history, examination and investigations followed by diagnostic curettage. Endometrial curretings were sent for histopathological examination. STATISTICAL ANALYSIS: Statistical Package for Social Sciences (SPSS V.16.0) and Microsoft Excel were used to carry statistical analysis of data. Data was analyzed with the help of descriptive statistics viz. %age, mean S.D. Graphically data was presented by bar and pie diagrams. RESULTS: Majority of the patients with postmenopausal bleeding were in the age of 45-55 years (63.8%), majority of cases 64(55.2%) were para 1-3, uterus was of normal size in 53 cases (45.7%). Mean age of onset of menopause was 48.7 years. Obesity was found in 40 cases (34.5%), hypertension in 35 cases (30.2%), and diabetes in 12 cases (10.3%). Out of the 116 cases studied; the most common cause of bleeding in the postmenopausal age group was endometrial hyperplasia in 41 out of 116(35.3%) followed by atrophic endometrium in 39 of 116(33.6%). Endometrial polyps were found in 9 (7.8%) cases, proliferative endometrium was found in 10(8.6%), endometritis was seen in 3(2.6%) cases, secretory endometrium in 1(0.9%) cases and adenofibroma in 1(0.9%) cases. The incidence of endometrial carcinoma in this study was 6% (7 out of 116 cases) mean age being 56.7 years and with duration of menopause more than 3 years. In 5 cases (4.3%) no endometrial tissue was obtained, hence no diagnosis could be made.