Background: Embryo transfer (ET) is one of the most crucial steps in IVF/ICSI treatment. Although it, apparently, seems simple, it is an integral part of IVF/ICSI and can affect the outcome of the whole treatment cycle. The majority of couples (approximately 80%) who undergo IVF reach the ET stage, yet few pregnancies occur. The pregnancy rate after ET is dependent on multiple factors including embryo quality, endometrial receptivity, and the technique of the ET. Aim of the Work: The aim of the current study is to investigate the clinical and ongoing clinical pregnancy rates in women who experience difficult embryo transfer (ET) after IVF/ICSI cycle. Patients and Methods: This prospective cohort study was conducted at Dar Al-Teb Infertility and IVF Centerbetween January 2017 and January 2018. The study included 417 women planned to undergo ET. Results: The biochemical, clinical and ongoing clinical pregnancy rates were significantly lower in women who had difficult ET when compared to women who had easy ET [ORs 0.5, 95% CI (0.31 to 0.83); 0.48, 95% CI (0.29 to 0.79); 0.36, 95% CI (0.21 to 0.62); respectively]. Conclusion: Difficult ET is associated with significantly reduced biochemical, clinical and ongoing clinical pregnancy rates. Recommendations: ET should be smooth with easy passage of the transfer catheter. Since any uterine manipulation during ET adversely affects IVF results, therefore precaution should be taken to identify possibly difficult ET cases in advance.