Background: Menstrual problems with all manifestations ranging from life-threatening bleeding to amen- orrhea are considered patterns of abnormal uterine bleeding (AUB), which is until now a popular reason for referral to the gynaecologic clinic and requires a special diagnostic tool. Objective: To assess the accuracy of hysteroscopy in diagnosing endometrial pathologies and to compare it with sonographic and histopathologic reports. Patients and Methods: A prospective study conducted in the Baghdad Teaching Hospital on 60 Iraqi females having varying complaints from abnormal uterine bleeding in pre- and post-menopausal women, infertility, and chronic pelvic pain with normal or abnormal ultrasound findings. Office hysteroscopy was done and an endometrial biopsy was obtained for histopathology for a period of 10 months between September 2020 and June 2021. Results: The current study showed that hysteroscopy was more accurate in diagnosing sensitivity of endo- metrial poly (100%), fibroids (83%), hyperplasia (84.2%), and cancer (50%) whereas ultrasounds were more accurate in diagnosing sensitivity to endometrial myoma (90%). Hysteroscopy and ultrasound showed low sensitivity in detecting endometrial cancer (50% and 34%, respectively). Conclusion: Although a transvaginal ultrasound was considered an integral part in the diagnosis of endo- metrial pathologies, it can be used for initial investigation, however, when suspecting endometrial pathol- ogy, hysteroscopy can be more advanced for evaluation, immediate treatment of endometrial masses, and obtaining targeted biopsies. Hysteroscopy showed high sensitivity in detecting endometrial polyps.
