Background: The aim of the study was to evaluate accuracy of the outpatient hysteroscopy. Materials and Methods: This was a retrospective cohort study of 494 women who underwent outpatient hysteroscopy after administration of non-steroidal anti-inflammatory agents with the 3.2 mm hysteroscope. Normal saline solution was used as the distension medium. All women were discharged in good general condition afterwards. Results: In cases of abnormal uterine bleeding, there was no apparent pathology found in 112 cases (83.6%). Detection rate (DR) of endometrial polyps was 88.7% with false positive rate (FPR) of 4.6%. Positive predictive value (PPV) was 82.7% with negative predictive value (NPV) of 93.1%. Detection rate (DR) of the submucosal fibroids was 57.7%. Positive predictive value (PPV) was 57.7% with negative predictive value (NPV) of 95.0%. Endometrial cancer was confirmed in ten cases (2.0%), being suspected in eight cases during the procedure. DR in case of the endometrial cancer was 80.0% with FPR of 0.4%. PPV was 66.7% with NPV) of 99.6%. Conclusions: Outpatient hysteroscopy seems to be an effective and accurate diagnostic tool.