Aim of the Work: was the assessment of the histological features of the uterine septum as regard the proportion of muscle fibers in relation to fibrous tissue to decide the best management whether incision or excision.
Patients and Methods: this study was carried out on 16 women with uterine septum in childbearing period complaining of either infertility or recurrent miscarriage fulfilling the inclusion criteria, attending to Ain Shams University Maternity Hospital between May 2017 and April 2018. The septum was incised or excised by scissors or by resectoscope, and then specimen was taken from the middle of the septum sample (A) and another specimen from the uterine wall sample (B). The retraction of the septal tissue on both sides was observed. The study included 16 specimens of uterine septum (A) and 16 specimens from uterine wall (B). Histopathological examination was done Results: There was a statistical significant difference between the uterine septum and uterine wall regarding amount of fibrous tissue, number of cells in connective tissue, amount of muscle tissue, amount of capillaries and number of vessels with muscle wall (P < 0.05). Poor retraction of the septal tissue was found in the muscular septum in contrast to good retraction that found in fibrous septum.  Conclusion: poor retraction of the septal tissue was found in the muscular septum in contrast to good retraction that found in fibrous septum.