Background: Postmenopausal bleeding is considered an important and alarming symptom both to the patient and to the gynecologist, and requires as complete evaluation as possible in order to ensure the absence of malignancy and to identify and treat high risk patients such as those with endometerial hyperplasia. The aim of the present study was to investigate the clinical significance and endometrial pathology in patients with postmenopausal bleeding (PMB) in terms of etiology, risks factors, incidence of malignancy, and histopathologicalevaluation. Methods:100 cases of PMB attending to Gynaecology Dept. of Hi–tech Medical College & Hospital, Bhubaneswar from 1st November 2016 to 31st October 2018 underwent a detailed history, clinical examination and full investigation, including full laboratory investigation, pelvic ultrasound, and examination under anesthesia (EUA) with dilatation and curettage and endometrial sampling. The age group of the patient was more than 40yrs. Results: It showed that Benign pathology was found in (43/100) cases. These included senile atrophic endometrium, endometrial hyperplasia, endometritis, endometrial polyps, cervicitis, and cervical polyps. Malignant pathology was found in (57) cases including (46) cases of cancer of the cervix, (07) cases of adenocarcinoma of the endometrium, ovarian malignancy (4) Conclusion :It is concluded that postmenopausal bleeding is an important symptom and requires careful and prompt evaluation to eliminate the possibility of malignancy as quickly aspossible.