SummaryDilatation and curettage (D&C) is still considered by many the method of choice for examining women with postmenopausal bleeding. However, only 10% of these women have an endometrial cancer. Ultrasound has long been used for studying pathology of the endometrium but did not gain much interest until vaginal sonography became available. Vaginal sonography for measuring endometrial thickness has proved to have a high detection rate and low false-positive rate for diagnosis of endometrial pathology. An endometrial thickness of ≤ 4mm (double layer) means that endometrial cancer almost can be excluded. This paper discusses further the use of vaginal sonography for examining the endometrium in women with postmenopausal bleeding.