We evaluated the efficacy of enhancing the vaginal ultrasound visualization of endometrial polyps and submucous fibroids using the intrauterine saline as a contrast medium in 30 women with abnormal uterine bleeding. Each woman underwent evaluation with a standard vaginal sonogram and then a saline-enhanced sonogram. For the latter, sterile saline was instilled into the uterine cavity with a soft polyethylene, intrauterine insemination cannula to enhance the visualization of intrauterine structures. The patients subsequently underwent hysteroscopy and endometrial sampling. The saline-enhanced vaginal sonohysterogram clearly improved the visualization of submucous myomas and endometrial polyps in 17 of 19 women. In four women it showed no evidence of myomas or polyps. In seven of the earlier procedures in this series, filling of the uterine cavity was too poor to use the results. We conclude that vaginal saline sonohysterogram is simple yet safe, and is a valuable preoperative diagnostic procedure.