Background: Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal woman.There are many causes including atrophy (59%), endometrial hyperplasia (17%), polyps (12%), endometrial cancer (10%), cervix cancer (1%).Other rare and unusual cases could be found in the literatures.Here we present a case of Postmenopausal Bleeding Related to Omental-uterine Varices in a Cirrhotic Patient.Case A 53-year-old woman presented with post-menopausal bleeding.Ultrasonography revealed a small intramural myoma (pathology confirmed myoma).Hysteroscopy and uterine curettage was non-diagnostic.Laparoscopic hysterectomy was performed due to recurrent bleeding episodes with anemia (Hb 7.2g/dt).During the procedure, a large patch of omental adhesion to the anterior lower uterus with multiple serpiginous, dilated, blue colored veins was found incidentally.The diameter of the largest vein was greater than one cm.The veins were coagulated with PK coagulator forceps and laparoscopic hysterectomy was performed instead of varices ligation only due to its possibility of recurrence.The ectopic omental-uterine varices was diagnosed with its typical pictures of numerous, dilated, tortuous veins.The patient has chronic diabetes mellitus, cirrhosis and three prior cesarean sections.Portal hypertension is a common sequelae of cirrhosis and can lead to the development of porto-systemic shunts.These shunts are associated with high morbidity and mortality.The rare occurrence of uterine bleeding was due to an uncommon finding of ectopic varices that resulted from a porto-systemic shunt between the gastroepiploic vein and the uterine vein.Collaterals within adhesions from previous surgeries are the usual mechanism for the development of such ectopic varices.Conclusion: Although postmenopausal bleeding is a common symptom, this unusual clinical presentation of postmenopausai bleeding in the case of ectopic varices is notable.Clinical awareness of this unusual presentation is important.