Objective: To evaluate the occurrence of endometrial polyp malignancy in pre- and postmenopausal women with or without symptoms. Materials and Methods: A retrospective study was performed on 351 patients with endometrial polyps diagnosed by hysteroscopy. Results: Histological findings of biopsies obtained by operative hysteroscopy confirmed the presence of a simple endometrial polyp in 179 cases, polyps with typical simple hyperplasia in 42 cases, polyps with typical complex hyperplasia in 24 cases, polyps with atypical complex hyperplasia in three cases; carcinomatous polyps in seven cases; atrophic polyps in 17 cases; functional polyps in 56 cases; and inadequate sample in 23 cases. All seven patients with adenocarcinoma were symptomatic; six out of seven patients with adenocarcinoma were in postmenopause and one was in premenopause. The association between menopausal status and symptoms, and the presence of a malignant lesion was statistically significant (p < 0.001). Conclusions: This study revealed that prevalence of endometrial polyp malignant transformation was ≤2.84% in postmenopausal and symptomatic patients.