Background: Abnormal uterine bleeding is a frequently encountered gynecologic complaint in perimenopausal woman. The objective of the study was to correlate the ultrasonographic finding with histopathological examination in perimenopausal AUB. Methods: This prospective study was carried out over 6 months in a teaching hospital. A total of 100 women in the age group of 40-51yrs who presented with AUB were included. After selecting the patient with eligibility criteria, detailed clinical history, systemic, gynecological examinations and investigations were done as per proforma. USG study of endometrial pattern and thickness was measured followed by dilatation and curettage and HPE was done. The data collected was entered in MS EXCEL spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0 (Trial Version) Result: The commonest menstrual irregularity was heavy and prolonged menstrual bleeding (49%). Endometrial thickness >15 mm on USG was seen in (43%) patients, 9-15mm thickness(44%). On HPE, secretory phase endometrium(37%), proliferative phase (36%), endometrial hyperplasia(22%), disordered proliferative endometrium (2%) & endometrial carcinoma (3%) was seen. Conclusion: USG should be the first diagnostic step in evaluation of AUB. HPE is done to confirm the diagnosis. Accurate diagnosis of the causative factor of AUB is imperative for appropriate management