Background: Abnormal uterine bleeding (AUB) is associated with a wide variety of endometrium. Endometrial interpretation is valuable not only to find the etiology of AUB but also to rule out any organic cause for abnormal uterine bleeding. Fractional curettage is one of the most reliable and commonly performed diagnostic techniques used in the investigation of AUB. To evaluate the efficacy of endometrial aspiration cytology in the diagnosis of abnormal uterine bleeding by correlating it with histopathology.Methods: This comparative study to be conducted in100 patients attending antenatal clinic at Department of OBG, Tirunelveli Government medical college hospital from January 2018– July 2019. (17) months. Specific investigations like abdominal ultrasonography, thyroid profile, platelet count, bleeding time, clotting time, prothrombin time, etc were done whenever required. Informed consent was taken from all the study patients. Prior to Fractional curettage, endometrial aspiration was done using plastic disposable pipelines of 3 mm diameter.Results: The sensitivity of the cytology in detecting carcinoma of the endometrium was 83.3%. The specificity of cytology is 100%. Hence the test is highly specific in diagnosis. The positive predictive value is also 100% and the negative predictive value is 99%.Conclusions: It can also detect a few of the endometrial pathologies like endometrial hyperplasia, atrophy, and atypia. It is office Procedure. reduction in associated surgical risks, expense, post-operative pain, and need for operative anesthesia as seen in fractional curettage.