Purpose: To describe the clinical and histopathological characteristics of 12 patients with pyometra and highlight the increased incidence of gynecological malignancy in these patients. Materials and Methods: The authors examined the medical records of 12 patients with pyometra, who were treated between 2009 and 2013. Results: All patients were post-menopausal, and their mean age was 70.83 ± 6.978 years (min=61, max=82). To remove purulent fluid via dilation and because of the probability of malignancy, three patients (25%) underwent cervical biopsy and endometrial curettage; the other nine patients (75%) underwent curettage alone, with suitable antibiotic therapy. Of the 12 patients, nine (75%) had gynecologic malignancy [(endometrial cancer, n=5, 41.6%), (cervical cancer, n=3, 25%), (uterine leiomyosarcoma, n=l, 8.3%)]. In three (25%) patients, the cause of pyometra was benign pathologies, among which the most common were leiomyomas (n=2, 66.6%). Conclusion: Pyometra diagnosed during the post-menopausal period should be considered a complication caused by gynecological malignancy until proven otherwise.