Abstract Objective: To evaluate angiogenin levels in both tissue and serum of patients with ‎endometrial hyperplasia with and without atypia.‎ Methods: Sixty women were classified according to the histopathological findings of endometrium‎ into three groups. The control group consisted of 20 women with normal non-hyper plastic endometrium.‎ The second group included 20 women diagnosed as complex endometrial hyperplasia without atypia. The third group included 20 women diagnosed as complex endometrial hyperplasia with atypia. Serum and tissue angiogenin were measured by enzyme immunoassay (EIA) technique and confirmed in tissues with Western Blotting (WB) technique.‎ Results: There was a statistically significant increase in serum and tissue angiogenin levels of ‎endometrial hyperplasia groups compared to those of control group (P < 0.001). Serum and tissue angiogenin levels were with a statistically significant higher (P< 0.001) in group III compared to group II. The sensitivity of serum angiogenin to detect the potential possibility of endometrial hyperplasia with atypia in endometrial hyperplasia patients was 100%, specificity 85%, positive predictive value 86.9%, negative predictive value 100%, positive likelihood ratio 6.6%, negative likelihood ratio 0% and accuracy 91.7%.‎ Conclusion: Elevated levels of serum angiogenin in endometrial hyperplasia could assist in determining which patients are at high risk for atypical change requiring aggressive treatment.‎