Objective To investigate the clinical value of hysteroscopy in helping identify the etiology of intrauterine fluid collection in postmenopausal women.Methods One hundred and thirtyfour postmenopausal women with intrauterine fluid collection,detected via transvaginal sonography,were admitted in the department of gynecology and obstetrics at Beijing ChaoYang Hospital from May 2014 to October 2016.All clinical data were retrospectively analyzed.All patients underwent hysteroscopy and biopsy of the endometrium.The results of hysteroscopy were analyzed against biopsy results.Results Hysteroscopy revealed that 116 of the 134 cases had uterine fluid(86.6％).Based on hysteroscopy results,44 (37.9 ％) had endometritis,10 (8.6 ％) had atrophic endometritis,5 (4.3 ％) had endometrial carcinoma,and 7(6.0 ％)had endometrial polyps,but the case numbers and rates for these conditions from microscopic examination were39 (33.6％),15 (12.9％),6 (5.2％),and 7 (6.0 ％),respectively.When microscopic examination was used as the gold standard,the sensitivities and specificities of hysteroscopy in the diagnosis of endometritis,atrophic endometritis,endometrial cancer and endometrial polyps were 82.0 ％ and 85.7 ％,66.7 ％ and 97.1％,80.0 ％ and 98.2 ％,and 100.0％ and 97.3％,respectively.The diagnostic coincidence rates were 84.6％,93.2％,94.4％ and 97.4％,respectively.Conclusions Postmenopausal women with intrauterine fluid collection shown on transvaginal sonography should receive hysteroscopy for early detection of endometrial lesions.