Aim: The study was designed to evaluate the diagnostic efficacy of pipelle endometrial biopsy in patients with abnormal uterine haemorrhage in comparison to dilatation and curettage. Materials and methods: The prospective, observational, and comparative study that was conducted in the Obstetrics and Gynaecology Department. A total of 100 women who met the inclusion criteria and were attending the Gynaecology Out-Patient Department (OPD) with complaints of AUB were enrolled. The outpatient department conducted a comprehensive clinical evaluation of the patient, which encompassed a history, physical examination, and baseline investigations. Pipelle device endometrial sampling was performed without anaesthesia for diagnostic intervention, followed by D&C endometrial sampling under anaesthesia. The significance of study parameters on a categorical scale between two or more groups has been determined using Fisher/Chisquare exact test. Results: The age category of 40-45 years comprised the majority of the patients (40%). 48.2 ± 6.21 years was the average age of the patients. Parity 3 (44%) and parity 4 (29%) were the most prevalent presentations among the patients. The chief complaint of the majority of the patients was excessive menstrual bleeding (65%), followed by irregular bleeding (15%) and postmenopausal bleeding (12%). The most prevalent observation during USG was a normal uterus (47%), followed by a bulky uterus (24%), and a uterus with a fibroid (9%). The sample adequacy rate with D&C and Pipelle device/EB was 95% and 96%, respectively. In both methodologies, we observed an equal number of patients with proliferative endometrium (53%), and one patient (1%) had irregular shredding of endometrium during histopathological examination (HPE) of 100 cases. One patient underwent a Pipelle aspiration biopsy and exhibited a low number of spindles on HPE, with no indication of atypia. Conclusion: Endometrial biopsy with Pipelle is an outpatient procedure that generates 96.8% satisfactory samples. Additionally, it is being implemented frequently in patients with AUB who have hyperplasia and malignancy as a result of its exceptional sensitivity, specificity, and positive and negative predictive values.