Endometrium has a wide range of appearance as well as overlapping imaging features, adding to challenges faced while diagnosing endometrial lesions. Although USG is the first modality to detect the endometrial lesions, MRI provides more details about the lesion. Hence, we aimed to assess and compare USG and MRI in characterising endometrial pathologies and to compare their sensitivity, specificity, positive predictive values and negative predictive values for diagnosis using histopathology (HPE) as a gold standard. Aim: Our study aimed to evaluate the diagnostic value of MRI in endometrial pathologies in comparison to ultrasound. Materials and Methods: Hospital based Prospective Cross sectional study was done enrolling 40 patients who visited the gynaecology OPD and had endometrial lesions on USG. Results: Overall 20% of the lesions were malignant. The overall accuracy of MRI, and USG were 95%, and 85% respectively. There was a significant difference in accuracy between MRI and USG in diagnosing endometrial pathology. Conclusion: Our study suggests that all women with endometrial pathology identified on USG or in whom there is a strong clinical suspicion of disease should undergo MR pelvic imaging for better characterization of the pathology.