Background: More often than any other type of contra-ception, intrauterine contraceptive devices (IUCDs) are used in Egypt. In most cases, a non-guided procedure is used to insert IUCDs in office settings. Blind insertion possibly causes various complications including perfora-tion. It is recommended to conduct TVUS prior to inser-tion in order to determine the uterus's size and orienta-tion, as well as to rule out the possibility of pregnancy or pathology. Moreover use of TVUS during regular follow up may improve outcomes and help reduce IUCD related complications. 
Aim of the work: Compare ultrasound-guided and non-ultrasound-guided IUCD insertion techniques for proper placement, problems, time, and patient satisfaction during insertion and follow-up.
Patients and methods: The study recruited 200 women using copper TCu-380A that were randomly divided into two groups (Each of 100 females), subgroup U (where ultrasound guided technique before insertion, during in-sertion and follow up and subgroup B (with non-ultra-sound guided technique for IUCD insertion). The prima-ry outcome was measuring the proper device placement post-insertion and after the next menstruation. Secondary outcomes included measuring the incidence of complica-tions including perforation, expulsion, cervical problems, bradycardia, syncope, measuring patient satisfaction, as-sessment of difficult IUCD insertion and pain scores.  
Results: The overall incidence of complications was sta-tistically significantly higher in the non-ultrasound guid-ed technique group as compared to the ultrasound group. The duration for insertion was statistically significantly longer in the non-ultrasound guided technique group as compared to the ultrasound group. The Pain score during insertion was statistically significantly higher in the non-ultrasound guided technique group as compared to the ultrasound group. The degree of satisfaction was sta-tistically significantly higher in the ultrasound technique group. Conclusions: Several positive outcomes were linked to the use of TVUS during the insertion of IUCD, including a shorter inser-tion duration, lower pain levels, a higher de-gree of satisfaction, and a smaller frequency of problems. Also, TVUS scan during regu-lar follow up substantially help reduce IUCD related complications and improve continui-ty of the method.