Dysfunctional uterine bleeding (DUB) affects 20–30% women in the reproductive age group and accounts for 25% of all gynecological surgeries. Diagnosis of DUB is one of exclusion in which pregnancy, coagulopathy, pelvic diseases and malignancy needs to be ruled out. For evaluation of DUB, endometrial aspiration using Pipelle curette is a simple out- patient procedure with a sensitivity of 95% and specificity of 98.5%. With availability of various non hormonal (antifibrinolytics, COX inhibitors, ethamsylate and mifepristone) and hormonal agents and endometrial ablative procedures to control menstrual blood loss, hysterectomy rates can be reduced. Conservative surgical procedures include the first generation ablative techniques with a success rate of 80-90% and the second generation procedures which have comparable success rates but do not require hysteroscopy. Thus, conservative modalities are an attractive alternative approach in management of DUB and will decrease the morbidity and mortality associated with hysterectomy.