Introduction Postmenopausal metrorrhagia (PMMs) is a common reason for consultation in gynaecology. It may reveal, during exploration, a benign or malignant pathology that must be differentiated following a para-clinical assessment with the main pathology to eliminate being endometrial cancer. The goal of our study was to assess the correlation between ultrasound, hysteroscopy and histology in the exploration of endo-cavitary lesions when faced with PMMs. Materials and methods: This is a retrospective descriptive and analytic study, based on 90 patients treated for postmenopausal metrorrhagia (PMM) in the department of Gynaecology and Obstetrics II of HASSAN II teaching hospital of FES, from January 2014 to January 2017. Results: The mean age of the patients was 59 years. The correlation of the ultrasound and hysteroscopy data showed that the ultrasound presented sensitivity, specificity, PPV and NPV equal to 100% for endometrial atrophy. For hypertrophy, these values were respectively 74%, 95%, 88%, 87.5%. For the suspicion of cancer, the sensitivity was 100%, the specificity of 98.6%, the PPV of 93% and the NPV of 96%. As for the correlation between hysteroscopy-histology on biopsy, sensitivity, specificity, PPV and NPV were respectively 96.7%, 98.3%, 96.7% and 98.3% for hyperplasia and 94%, 100%, 100% and 98.6% for suspected cancer. The hysteroscopy-histology correlation on the surgical specimen showed 100% sensitivity, specificity, PPV and NPV for polyps and leiomyomas, respectively 96%, 92%, 83.8% and 98.3% for hyperplasia’s and values of 72%, 100%, 100% and 92% for suspected cancer. The degree of performance of each means of exploration was variable according to the lesion in question of the metrorrhagia and generally, the hysteroscopy was more reliable in the exploration of the MMPs than the ultrasound: Kappa of 0.74 against 0.50. Conclusion: Our results are consistent with the data in the literature, which attributes to hysteroscopy having a greater reliability compared to a pelvic ultrasound in the diagnosis of endo-cavitary lesions as the origin of postmenopausal metrorrhagia. An Ultrasound is the first-line examination in the exploration of PMMs, it should be coupled with diagnostic hysteroscopy and biopsy for better diagnostic accuracy.