Aim: This study was done to compare the efficacy of plain cervical dilatation and curettage (D&C) and hysteroscopic-guided biopsy in evaluating endometrial pathology and to compare the histopathology findings of hysterectomy specimen. Materials and methods: This study was done at the Obstetrics and Gynecology outpatient department (OPD) in Dr Chandramma Dayanand Sagar Institute of Medical Education and Research, Harohalli, Ramanagara, Karnataka, India over a period of 1 year from January 2021 to January 2022. A total of 100 perimenopausal and postmenopausal women complaining of abnormal uterine bleeding in gynecology OPD were included. Those women who are eligible for diagnostic D&C, cervical dilatation and endometrial curettage were done under i.v. sedation in the operation theater (OT) and the curetting was sent for histopathological examination (HPE). Those women who needs hysteroscopy, it was done under short general anesthesia and the sample was sent for histopathologic examination. Patients for whom hysterectomy was indicated following D&C or hysteroscopy would be followed for the histopathological findings. Results: Our cases range in the age-group of 40–55 years who presented with abnormal uterine bleeding (AUB) without local gynecological cause and with failure of medical treatment for at least 3 months. The mean duration between the endometrial curettage and the hysterectomy being 2.5 weeks. The highest correlation was seen in the endometrial phase, followed by complex and then by simple hyperplasia. Clinical significance: The main reason for choosing this study is to find the diagnostic modality with higher accuracy so as to avoid unnecessary hysterectomy in patients with AUB.