Hysteroscopy is a diagnostic test frequently undertaken to find out the cause of abnormal uterine bleeding. Hysteroscopy involves fluid or gas being injected via the cervix (neck of the womb) into the uterus (womb), which enables the visualisation of the cervical canal and uterine cavity with a hysteroscope (small telescopic camera). This can be a painful procedure. The purpose of this review was to determine which, if any, pain relief drug should be used during outpatient hysteroscopy. Analysis of 13 studies investigating 1881 women found evidence of benefit for pain relief with the use of analgesia during or within 30 minutes after the procedure, especially in post-menopausal women. Further high quality, well powered trials should be undertaken in order to provide the data necessary to estimate the efficacy of oral analgesics, the optimal route of administration, and dose of local anaesthetics to be used.