Background: Postmenopausal bleeding is generally regarded as an ominous and serious alarm of genital pathologies; represents 5% of all gynecological visits. To develop the treatment procedure of postmenopausal bleeding and to increase the success rate of such treatment, knowledge on the histopathological pattern of endometrium in menopausal women with postmenopausal bleeding is very essential. Aim of the study: The aim of the study was to evaluate various causes of postmenopausal bleeding based on histopathology, and the percentage of various benign, premalignant and malignant endometrial and cervical lesions. Materials and Methods: This was a cross-sectional analytical study which was conducted at OPD, Department of Gynecology and Obstetrics, Popular Medical College, Dhaka, Bangladesh during the period from January 2018 to December 2018. In total 45 menopausal women diagnosed as patients among them 31 patients with postmenopausal bleeding were selected as the study population. Ethical clearance had been taken from the ethical committee of the medical college. All data were processed, analyzed, and disseminated by MS Office and SPSS version 20 as per need. Result: In this study according to the diagnosis report, we found the highest number of participants were with an endometrial polyp and/or chronic cervicitis which was 22.56% separately. No malignancy was seen among 19.35%, Besides these, squamous metaplasia was 19.35%, endometrial adenocarcinoma 9.68%, endometrial hyperplasia with atypia 6.45%, endometrial hyperplasia without atypia 6.45%, papillary adenocarcinoma 3.23% and finally smile cystic change of endometrium 3.23%. Conclusion: Endometrial polyp, no malignancy, endometrial adenocarcinoma, and chronic cervicitis are the most potential endometrial characteristics of menopausal women with postmenopausal bleeding. On the other hand, abdominal pain is the most potential associated symptom of patients with postmenopausal bleeding.