The present work investigates the stability properties of the flow in a 90°-bend pipe with curvature δ=R/Rc=1/3, with R being the radius of the cross-section of the pipe and Rc the radius of curvature at the pipe centreline. Direct numerical simulations (DNS) for values of the bulk Reynolds number Reb=UbD/ν between 2000 and 3000 are performed. The bulk Reynolds number is based on the bulk velocity Ub, the pipe diameter D, and the kinematic viscosity ν. The flow is found to be steady for Reb⩽2500, with two main pairs of symmetric, counter-rotating vortices in the section of the pipe downstream of the bend. The presence of two recirculation regions is detected inside the bend: one on the outer wall and the other on the inner side. For Reb⩾2550, the flow exhibits a periodic behaviour, oscillating with a fundamental non-dimensional frequency St=fD/Ub=0.23. A global stability analysis is performed in order to determine the cause of the transition from the steady to the periodic regime. The spectrum of the linearised Navier-Stokes operator reveals a pair of complex conjugate eigenvalues with positive real part, hence the transition is ascribed to a Hopf bifurcation occurring at Reb,cr≈2531, a value much lower than the critical Reynolds number for the flow in a torus with the same curvature. The velocity components of the unstable direct and adjoint eigenmodes are investigated, and they display a large spatial separation, most likely due to the non-normality of the linearised Navier-Stokes operator. Thus, the core of the instability, also known in the literature as the wavemaker, is sought performing an analysis of the structural sensitivity of the unstable eigenmode to spatially localised feedbacks. The region located 15° downstream of the bend inlet, on the outer wall, is the most receptive to this kind of perturbations, and thus corresponds to where the instability originates. Since this region coincides with the outer-wall separation bubble, it is concluded that the instability is linked to the strong shear by the backflow phenomena. The present results are relevant for technical applications where bent pipes are frequently used, and their stability properties have hitherto not been studied.