Objectives : To evaluate the effectiveness of hyperchoic line sign circumscribing the central endometrial complex at endovaginal ultrasound to detect focally growing lesions in the uterine cavity and to discriminate between endometrial polyps, submucous myomas and endometrial malignancy in women with postmenopausal bleeding and endometrial thickness > 5 mm. Methods : 50 women with postmenopausal bleeding and endometrium > 5 mm underwent endovaginal ultrasonography followed by hysterosonography. The endovaginal ultrasound scans and companion hysterosonograms were retrospectively reviewed and correlated with histopathologic data.