The abnormal uterine bleeding, present in 30% of women, can arise from 1 of 4 broad etiologic categories: pregnancy related etiologies, from direct anatomic of uterine pathology, from the endocrine mediated sequelae of anovulation and from disorders of coagulation. I review the current literature, on the database of OVID, PubMED and Cochrane library, and the evidences to support a reasonable clinical management about diagnosis and treatment in favor of the health and economy of the women with the most effi cient and less invasive manner possible. The result was an algorithm, with evidence based medicine, that supports the proposals of this review.