The study was done to find out the role of saline infusion sonohysterography in the diagnosis of abnormal uterine bleeding. 50 patients in the perimenopausal and postmenopausal age group with abnormal uterine bleeding were subjected to saline infusion sonohysterography. The findings obtained were compared with histopathology of endometrium in all patients and hysterectomy specimens in 35 patients. When histopathological examination was taken as confirmatory, SIS findings had 100% sensitivity and negative predictive value but specificity and positive predictive value were 42% and 37% respectively. When hysterectomy specimens were taken as gold standard, sensitivity and negative predictive value were each 100 % and specificity was 97% for polyp, submucous fibroids and malignancy. The positive predictive value was 75% for both submucous fibroids and polyps and 66.6% for malignancy. SIS is a cost effective minimally invasive first line investigation in patients with abnormal uterine bleeding.