The authors evaluate the diagnostic role of hysteroscopy and sonography in the early detection of endometrial cancer. In their experience diagnostic accuracy of transabdominal ultrasound was 87.5%; the introduction of transvaginal sonography increased it up to 95.8%, whereas hysteroscopy had diagnostic accuracy of 100%. The hysteroscopy allowed us to establish cervical canal involvement in 100% of cases. Since sonography is well accepted by patients, the authors propose to perform it in high risk patients once a year as a first level exam to show abnormal endometrial echoes. Therefore patients can be selected to undergo hysteroscopy and, if necessary, biopsy.