Introduction: Endometrial hyperplasia (EH) is a pathological condition characterized by the proliferation of endometrial glands, which can range from simple hyperplasia to complex atypical forms with a signifcant risk of progression to endometrial carcinoma. Histopathological evaluation of endometrial samplings plays a crucial role in the diagnosis, classifcation, and management of EH.

Aim: This study aims to evaluate the histopathological spectrum of endometrial hyperplasia in endometrial samplings, assess the prevalence of various subtypes, and determine their association with clinical and demographic factors to aid in early diagnosis, risk assessment and appropriate management.

Material & Methods: A cross sectional descriptive study was conducted on endometrial samples obtained from patient with suspected endometrial hyperplasia. The specimens received for histopathological evaluation at histopathology section in Tertiary care hospital from October 2020 to September 2022. Relevant clinical data, including age, symptoms, and associated risk factors, were analysed.

Results: The study fndings highlight the distribution of different EH subtypes, including EH with atypia and EH without atypia. Out of total 147 cases of EH; 9 cases (6.1%) were histopathologically classifed as EH with atypia and 138 cases (93.8%) were EH without atypia. The commonest age group of EH with atypia was 41 to 50 years followed by 51 to 60 years and EH without atypia was 31 to 40 years. The most common clinical presentation was abnormal uterine bleeding.

Conclusion: Histopathological evaluation remains the gold standard for diagnosing and classifying endometrial hyperplasia. Accurate assessment of endometrial samples aids in risk stratifcation and guides appropriate clinical management, thereby preventing the progression to endometrial carcinoma.