ObjectiveTo assess the role of ultrasound with respect to management decisions in premenopausal women with abnormal uterine bleeding attending an outpatient hysteroscopy clinic.DesignRetrospective analysis of ultrasound and hysteroscopic findings, in 264 women referred with abnormal uterine bleeding.SettingOutpatient hysteroscopy clinic in a busy district general hospital.ResultsIn situations where hysteroscopy findings were normal, additional information gained from a preliminary ultrasound did not affect management decisions. No malignant adnexal pathology was detected, and ultrasound assessment of the endometrium did not correlate well with either hysteroscopic or histological findings.ConclusionUltrasound findings do not alter management decisions in this situation. The presence of irregular bleeding, and patients' prior expectations, are more significant determinants.