Abnormal vaginal bleeding is a common cause of complaint for the women in reproductive age. In the management identifying possible causes is crucial in order to establish the right treatment strategy. Significant morbidity and mortality still might be associated with abnormal vaginal bleeding depending much on the cause and the severity of the bleeding. In the light of the large trials, and of the new minimal invasive approach in uterine pathology, this paper tries to get new insight into the management either medical or surgical for this condition.