Objectives: The aim of this study was to evaluate the association between sonographic characteristics and endometrial histopathology in patients with postmenopausal bleeding and evaluate the measurement of uterine artery resistance index and pulsation index in the differentiation between malignant and non-malignant endometrial pathology. Study design: Observational, cross-section study. Setting: Benha university hospital during the period from January 2011 to December 2011. Patients and Methods: Sixty women complaining of postmenopausal bleeding were investigated by trans-vaginal ultrasound to assess sonographic characteristics of the endometrium and by color Doppler ultrasound to measure the resistance and pulsation indices of the uterine arteries. Results were compared with those obtained by histopathology examination of an endometrial biopsy. Outcome measures: The association between histopathology and sonographic characteristics of the endometrium and measurement of uterine artery resistance and pulsation indices to differentiate between malignant and non malignant endometrial pathology. Results: A significant positive association was found between endometrial carcinoma and endometrial thickness >10 mm, hyperechogenic endometrium, presence of fluid in the endometrial cavity and non identification of the sub-endometrial halo (P