Background: Submucous fibroid, endometrial polyps, congenital uterine abnormalities and intrauterine adhesions are all potential causes of infertility. Distortion of uterine cavity by a fibroid or a septum can lead to implantation failure and recurrent early miscarriage. Traditionally, transvaginal ultrasound (TVUS) has been the first-line diagnostic tool for evaluating uterine diseases, also considering that gynecologists are familiar with the technique since it is included in the basic training in obstetrics and gynecology. Certainly, TVUS is an easy, fast and cheap method widely used. Objective: To evaluate the accuracy of 2D transvaginal ultrasonography (TVS) compared with hysteroscopy in diagnosis of intrauterine pathology in infertile women. Patients and Methods: This comparative prospective cohort study included 160 infertile women who had undergone transvaginal ultrasonography (TVS) compared with hysteroscopy in diagnosis of intrauterine pathology. The study was conducted at Ghamra Military Hospital. Cases were included in the study during the period between February 2018 and Jun 2021. All candidates included on the study underwent transvaginal ultrasonography using a Voluson 730 machine, and diagnostic hysteroscopy was done postmenstrual. TVS and diagnostic hysteroscopy were carried out during the same cycle. Results: TVS had a misdiagnosis in 18 cases at rate of 11.25 %. Ten patients have endometrial polyps, three have submucous fibroid, three were intrauterine adhesions, and two septate uterus. Conclusion: Diagnostic hysteroscopy was superior to two-dimensional TVS in the diagnosis of intrauterine pathology. Diagnostic hysteroscopy gave more informations than traditional two-dimensional TVS ultrasound. Hysteroscopy not only provided accurate visual assessment of the uterine cavity, but also provided a chance to treat any pathology detected during the examination.