Objective: To study the prevalence of various histopathological changes, patterns and lesions of endometrium in women with postmenopausal bleeding. Methodology: All the fixed specimens were processed and embedded in paraffin wax. Multiple serial sections of 4-5 microns thickness were obtained from the paraffin block and then stained with H & E. The observations in our study were analyzed using SPSS software version 11.5. The average values are statistically calculated using Microsoft Excel computer software. Results: This was a prospective, non interventional and observational hospital based cross sectional one year study carried out in histopathology department on endometrial biopsies and hysterectomy specimens. Out of 50 cases, postmenopausal bleeding presented at a mean age of 53.38 years and was most common within 5 years of attaining menopause. Among the endometrial causes of postmenopausal bleeding, 16% were due to benign conditions, 10% were due to malignancy and in 74 % of cases were because of non organic causes comprising of proliferative, secretory and atrophic endometrium. Atrophic endometrium was most common among non organic causes ,endometrial polyp was most common among the benign causes followed by endometrial endometrioid carcinoma was a major finding among the malignant causes.