Objective : To compare three-dimensional transvaginal sonography (3D-TYS) (non invasive) and hysteroscopy (minimally invasive) as a diagnostic tool in patients suffering from abnormal uterine bleeding (AUB). Design: A prospective randomized comparative study. Results: Both hysteroscopy and 3D-TYS showed 100% sensitivity and specificity in diagnosing atrophic endometrium and suspecting malignancy. However, in cases of hyperplasia, 3D-TVS had the same 100% sensitivity hut less specificity than hysteroscopy. On the other hand, in cases of polyps 3D-TYS had less sensitivity and specificity than hysteroscopy. Conclusion: Both hysteroscopy (minimally invsasive) and 30-TYS have the same accuracy in diagnosing atrophic endometrium and suspected malignancy, but Hysterescopy is superior than 3D-TYS in diagnosing hyperplasia and polyps in patients suffering from AUB.Abnormal uterine bleeding is an alarming symptom that requires accurate diagnosis in order to exclude cervical and endometrial diseases.

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