BACKGROUND: Sarcoidosis is a multisystem disease that rarely affects the female genital tract. It has been found the endometrium but has never been reported as a cause of postmenopausal bleeding. CASE: A 53-year-old, postmenopausal women presented complaining of a single, five-day episode of vaginal bleeding. An endometrial biopsy revealed many noncaseating granulomas with sarcoid-type asteroid bodies. The remainder of the work-up was negative, and the symptoms spontaneously resolved. CONCLUSION: Sarcoidosis can present as a focal disease and should be considered in the differential diagnosis of granulomatous disease of the endometrium.