Objective: To study diagnosis value of Hysteroscopic examination for patients with behind menopause vaginal bleeding and safety of Nd: YAG laser ablation of endometrial polyps and submucous leiomyoma. Methods: A total of 139 patients with behind menopause vaginal bleeding were included in this group, recruited from the outpatient department of Obstetrics and Gynecology Hospital of Shanghai Fu Dan University during the period from April 1996 to October 2001. According to diagnostic outcome of hysteoscopic Nd: YAG laser ablation, respectively proceed dilation and curettage and hyste-roscopic Nd:YAG laser ablation. There is a contrast analysis between hysteroscopic examination and pathological diagnosis. Results: There were 100% sensitivity and particularly in diagnosis of endometrial carcinoma -uterine sarcoma-.submucous leiomyoma and atrophic endometritis by Hysteroscopic examination, sensitivity of endometrial polyps under Hysteroscopy examination was 97.1% , particularity was 100%. ．Hysteroscopic exarninatlon Was highly in accordance with pathologic diagnosis．All surgical operations were completed successfully．The average uterine depth Was 6．8cm(6—9)and the average operative time Was 3．0±10．2 minutes，patients with behind menopause vaginal bleeding were able to endure hysteroscopicexamination．No serious complications oc curred during or after ope ration．Th e intrauterine neoplasms disappeared in 83 cases a follow —up period of 1—3 month．Conclusion：Hysteroscopic examination is of great sign ificance for cause of disease behind menopause vaginal bleeding．For patients having diagnosed endometrial polyps and submucous leiomyma，hysteroscopic Nd：YAG laser ablation is an efective and safe approach of treatment.