Background and Aims: Use of intrauterine contraceptive device (IUCD) is now a common practice. The present study was taken up to study the clinicopathological changes in endometrium following use of IUCD. Methods: Endometrium obtained from 65 cases who had IUCD of varying duration, presenting with different symptoms were studied by Hematoxylin and Eosin stained slides. Results: Patients presented with various menstrual irregularities and pelvic inflammatory disease. Duration of IUCD use ranged from 4 months to 10 years. The spectrum of endometrial changes were interstitial edema 22(33.8%), hemorrhage 36(55.3%), focal hyperplasia 18(27.6%), diffuse hyperplasia 2(3%), cystoglandular hyperplasia 4(6.1%), predecidual changes 5(7.6%), inflammatory cell infiltrate 9(13.8%), lymphoid follicles 2(3%), vascular changes 2(3%), metaplasia 1(1.5%). Conclusion: The present study tries to focus on the spectrum of endometrial changes associated with IUCD use, their clinical symptomatology and possible pathogenetic mechanisms. The endometrial changes were possibly due to inflammation, hyperplasia and metaplasia induced by IUCD.