This study was carried out on a total of 339 postpartum Holstein cows over a period of three and half years starting from November 2010 until April 2014. Out of these cows, 50 animals were free from urovagina and kept as control, while the remaining 289 cows were suffering from different degrees of urovagina (mild degree, n=135; moderate degree, n=149 and severe degree, n=5). At the time of first postpartum insemination, cows with urovagina were classified into untreated control group (included 45, 41and 2 cows with mild, moderate and severe urovagina, respectively) and saline flushed alone (included 45, 48 and only one animals with mild, moderate and severe urovagina, respectively) or in combination with penicillin-streptomycine (included 42, 60 and 2 cows with mild, moderate and severe urovagina, respectively). The first insemination conception rate decreased significantly (p ≤ 0.01) in untreated cows with moderate urovagina, but not in cows with mild urovagina compared to that of normal animals without urovagina. Moreover, in cows with mild urovagina, neither saline flushing of the genital tract alone nor in combination with antibiotic improved the first postpartum insemination conception rate. On the other hand, in cows with moderate urovagina, the first insemination conception rate tended to increase (p= 0.07) for cows flushed with saline alone and showed a significant (p ≤ 0.05) increase for those animals flushed with saline mixed with antibiotic as compared with untreated control cases of moderate urovagina.