Abnormal uterine bleeding is one of the common causes for referrals of gynecologic clinics. The routine methods of its evaluation are endometrial biopsy, diagnostic curettage and hysteroscopy. Vaginal or abdominal sonohystography have been presented as a diagnostic method for such cases. This study was performed on referrals of Mahdieh hospital to evaluate the diagnostic efficiency of sonohysytrography for bleeding abnormalities during the years 1998-99.TVSH was performed on 100patients with abnormal uterine bleeding and an indication of diagnostic curettage before surgery. The observations were recorded as a normal uterine cavity, hyperplasia, polyp, cancer and atrophy. Then the results were compared with the pathological findings and its specificity, sensitivity and positive and negative predictive values were determined.It was found out that vaginal sonohystrography is helpful in diagnosis of 32 out of 34 cases of abnormal endometrium (with a sensitivity, specificity, and positive and negative values of 94, 89, 82 and 96% respectively), 25 out of 27 cases of endometrial hyperplasia (with a sensitivity, specificity, and positive and negative values of 83, 93, 83 and 97% respectively), 7 out of 9 cases of endometrial polyp (with a sensitivity, specificity, and positive and negative values of 83, 95,58 and 98% respectively), 3 out of 4 cases of atrophy (with a sensitivity, specificity, and positive and negative values of 75, 100, 100 and 94% respectively) and 2 out of 2 cases (100%) of the endometrial cancer.McNemar test showed that diagnosing efficacy of TVSH is equitable to pathological tests in focal cases. Vaginal sonohystrography is a high fidelity, easy to perform and fast method with no complication and it recommended to be used for early evaluation of patients with abnormal uterine bleeding.