Background: Endometrial polyps are localized overgrowths of the endometrium composed of irregular endometrial glands, fibrous stroma, and thick-walled blood vessels. Although most lesions are benign, histological assessment remains essential to identify atypical hyperplasia or malignant transformation.

Methods: This was a retrospective descriptive study conducted over five years, from January 1, 2017 to December 31, 2021, including all histologically confirmed cases of endometrial polyps diagnosed at the Department of Pathology, Joseph Ravoahangy Andrianavalona University Hospital Center (CHU/JRA), Antananarivo.

Results: Fifty-four cases were included. The mean age was 45.8 ± 11.5 years, ranging from 23 to 66 years. Metrorrhagia was the main clinical presentation in 36 cases (66.7%). Postmenopausal women were predominant (70.4%). Associated lesions were found in 14.8% of cases, mainly leiomyoma. Biopsy-curettage was the most frequent sampling method (64.8%). Most polyps were ≥1.5 cm (83.3%) and solitary. Histologically, 94.4% were benign, 3.7% were pre-cancerous and 1.9% were malignant. Cytologic atypia was observed in 5.6% of cases.

Conclusion: Endometrial polyps in this series occurred mostly in peri- or postmenopausal women and were mainly revealed by metrorrhagia. Histological examination is crucial, as a small proportion of lesions may be pre-cancerous or malignant.