Abstract Aim: To compare the efficacy of Bipolar endometrial resection (BER) with that of non descent vaginal hysterectomy (NDVH) in control of heavy menstrual bleeding (HMB) induced by leiomyoma. Patients and Methods: An open label randomized controlled trial was conducted between February 2013 and October 2014 in Benha University Hospital, Benha, Egypt. Eligible women with HMB (Aged ( 40 years and ( 50 years, uterine size ( 12 weeks of pregnancy, leiomyoma ( 3 cm, uterocervical ( 12 cm) were randomly assigned (1 : 1) to undergo BER or NDVH by closed envelopes method. The primary outcome was the number of women in the BER group with HMB 6 months after surgery. Analyses were by intention to treat. Results: Each group contained 20 women. No women in BER had HMB at 6 months. Twelve women were amenorrheic and eight women were hypomenorrheic by 6 months. Conclusion: BER can replace NDVH in some perimenopausal women to control HMB induced by small leiomyomas. Keyword: BER, NDVH, EA, HMB.