Objectives: To determine the pre-malignant and malignant potential o f endomet rial polyps and to assess whether different clinical parameters are associated w ith malignancy in the polyps. Study design: Four hundred and thirty consecutive cases of hysteroscopic diagnosis of endometrial polyp were retriev ed. The medical records, preoperative vaginal sonography results and histopathol ogy findings were reviewed. Statistical analysis was performed. Results: Hystero scopy truly identi-fied endometrial polyps in 95.7%of the cases. In 11.4%case s, hyperplasia without atypia was found in the endometrial polyp. In 3.3 and 3.0 %of women pre-malignant or malignant conditions were found in the polyp. Older age, menopause status and polyps larger than 1.5 cm were associated with signif icant pre-malignant or malignant changes, although the positive predictive valu e for malignancy was low. All the malignant polyps were diagnosed only in postme nopausal women. The presence of postmenopausal or irregular vaginal bleeding, wa s not a predictor of malignancy in the polyp. Conclusions: Postmenopausal women with endometrial polyps are at increased risk of malignancy in the polyp. Those patients, whether symptomatic or not should be evaluated by hysteroscopic resect ion of the polyps. Asymptomatic premenopausal patients with polyps smaller than 1.5 cm can be observed. Objectives: To determine the pre-malignant and malignant potential of endomet rial polyps and to assess whether different clinical parameters are associated w ith malignancy in the polyps. Study design: Four hundred and thirty consecutive cases of hysteroscopic diagnosis of endometrial polyp were retriev ed. Results: Hystero scopy truly identi-fied endometrial polyps in 95.7% of the cases. In 11.4% case s, hyperplasia without atypia was found in the In 3.3 and 3.0% of women pre-malignant or malignant conditions were found in the polyp. Older age, menopause status and polyps larger than 1.5 cm were associated with signif icant pre-malignant or malignant changes, although the positive predictive value e for malignancy was low. All the malignant polyps were diagnosed only in postme nopausal women. The presence of postmenopausal or ir Regular vaginal bleeding, wa s not a predictor of malignancy in the polyp. Conclusions: Postmenopausal women with endometrial polyps are at increased risk of malignancy in the polyp. Those patients, whether symptomatic or not be be evaluated by hysteroscopic resection of the polyps. Asymptomatic premenopausal patients with polyps smaller than 1.5 cm can be observed.