Cause of Abnormal Uterine bleeding in postmenopausal women from simple atrophic vaginitis to endometrial carcinoma. Saline hystero sonography is a simple and cost effective method with high sensitivity to detect uterine abnormalities causing postmenopausal bleeding as it is a safe, economical and noninvasive alternative to hysteroscopy. Objective: To evaluate the diagnostic accuracy of Saline hystero sonography in detecting endometrial hyperplasia in women with Postmenopausal bleeding by taking histopathology as gold standard Settings: Department of obstetrics and gynecology, PMC Allied Hospital, Faisalabad Duration Of Study: 6 months after approval From: 01-02-2017 to 31-07-2017 Study design; Cross sectional (validation) study Method: After receiving patients in outdoor patient department or after admission in ward ,proper history and relevant examination of patient was done. Then preparartion was made for the procedure. Patient was counseled and technique explained to her. Then folleys catheter no 12 was passed in cervix and sonography was done while instilling normal saline through cervical catheter and scan pictures were frozen and results were given by expert gynecologist of Allied Hospital, Faisalabad. Histopathology specimen was sent to pathology lab. Results: 120 cases were enrolled. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of saline hysterosonography in detecting endometrial hyperplasia was recorded as 96.15%,91,49%,75.76%,98.85% and 92.5% respectively. Conclusion: Saline hysterosonography is a simple and cost effective method with high sensitivity to detect uterine abnormalities causing post-menopausal bleeding as it is a safe, economical and noninvasive alternative to hysteroscopy. Further in many units in Pakistan hysteroscopy is not available, so it can be replaced in local units by saline hysterosonography. Keywords: Saline hysterosonography, Endometrial hyperplasia, postmenopausal bleeding.