Endovaginal scanning (EVS) of the endometrium has recently been proposed as a method for the investigation of the endometrial mucosa. In this study, the specificity and sensitivity of EVS have been compared with endometrial cytology and D&C to discriminate between a normal and pathological endometrium. The study included 105 women who underwent preoperative endovaginal ultrasound investigation, endometrial cytology, and D&C because of postmenopausal bleeding. A specificity of 81% and a sensitivity of 97% in diagnosing morphological alterations by means of endovaginal ultrasound was found. The corresponding figures for cytological evaluation were 81 and 58%, respectively. We conclude that endovaginal ultrasound is a valuable diagnostic instrument for detecting pathological conditions in the uterine mucosa and as sensitive as endometrial cytology or D&C.