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Objective: The aim of this study was to evaluate the accuracy of 3D transvaginal sonography and power Doppler in the differentiation between endometrial hyperplasia and endometrial carcinoma. Patients and methods: Forty-two women suffering from abnormal uterine bleeding (AUB) were examined by 3D TV sonography and power Doppler angiography and all the sonographic findings and Doppler indices were recorded and evaluated. Lesions were then classified as benign or malignant according to imaging findings and the results were then correlated with histopathology results. Results: Significant improvement of the sensitivity and specificity was found in differentiating between endometrial hyperplasia and endometrial carcinoma when we combined the imaging findings of 3DTV sonography and the indices of power Doppler. Conclusion: Adding power Doppler to 3D TV sonography has added value in the differentiation between endometrial carcinoma and hyperplasia.