Introduction: Present study was conducted to To study the etiopathology and incidence of benign and malignant causes of of perimenopausal bleeding. Methodology: The was a prospective Study in the Department of Obstetrics and Gynecology, P.B.M. Hospital, S.P. Medical College, Bikaner on 300 patients. Ultrasonographic evaluation of the patient was performed to look for endometrial thickness, anatomical lesion–polyp, fibroid etc. Endometrial Biopsy was done and specimen was sent for histopathologic report (HPE). Results: We found that Polymenorrhoea was present in 53.7%, followed by Menorrhagia + intermenstrual bleeding (menometrorrhagia) (13%). 54% females were having Thickened endometrium, 14% had Uterus size increased with no specific feature, 11.3% had endometrial polyp, 10% had fibroid uterus, 6.7% had ovarian cyst and 4% had adenomyosis. 35.7 % have normal size uterus and 64.3% have bulky uterus. 35.3% patients had uterus size of 6–8 week, 49% had Proliferative endometrium followed by 32.7% patients had endometrial hyperplasia, 13.6% had Secretory endometrium. Conclusion: We concluded that menorrhagia and intermenstrual bleeding are mostly correlated with abnormal endometrial histopathological findings.