Objective — to evaluate the efficiency of microwave endometrial ablation in postmenopausal patients with recurrent endometrial hyperplastic processes, by using the current diagnostic methods. Subject and methods. Eighty postmenopausal patients aged 52 to 78 years with recurrent hyperplastic processes were examined. Before admitted to hospital, all the patients had undergone separate diagnostic scraping of the mucosa of the uterine cavity wall once to thrice under hysteroscopic guidance for recurrent endometrial hyperplastic processes. Histological examination found that all the patients had benign endometrial changes (endometrial polyps (n=70) and glandular cystic hyperplasia (n=10). Immediately prior to microwave endometrial ablation, all the patients underwent hysteroscopy, which revealed thin endometrium in 74 patients and local endometrial thickening in 6; separate diagnostic curettage of the uterine mucosa was repeatedly done in these patients; histological examinations did not show atypical cells. For diagnostic purposes, all the patients underwent two- and three-dimensional ultrasound before and 1, 3, 6, 12, 15, 18, 24, and 36 months after microwave endometrial ablation during a follow-up. Three-dimensional multiplanar reconstruction was used to obtain the most informative contiguous uterine coronal slices of 0.5 mm thickness. Results. A complete clinical effect after microwave endometrial ablation was observed in the 80 patients. Obtaining the most informative uterine coronal sections for three-dimensional sonography could trace changes in the configuration of the uterine cavity, as well as the stages of Asherman’s syndrome. Conclusion. Microwave endometrial ablation is a safe and feasible method to treat postmenopausal patients with endometrial hyperplastic processes. Prior to the above intervention, it is appropriate to carry out control hysteroscopy and separate diagnostic curettage of the uterine wall mucosa with histological examination of its scrapes. The criteria for the efficiency of microwave endometrial ablation are as follows: no genital tract bleeding; registration of the development of Asherman’s syndrome; no blood flow in the radial and basal uterine arteries of the uterus at color Doppler mapping.