Spontaneous abortion is the most common complication of pregnancy and is responsible for significant emotional distress to couples desiring children. Recurrent abortion was classically defined as the occurrence of three or more consecutive clinically recognized pregnancy losses before 20 weeks from the last menstrual period.The present work was performed on a group of twenty patients complaining of recurrent first trimesteric abortion attending the obstetrics and gynecology outpatient clinic in Kasr El-Aini Hospital, Cairo University. All patients were subjected to careful history taking and through gynecological examination. They were subjected to Hysteroscopy, Hysterosalpingography and Transvaginal ultrasonography. This study was done for evaluation the diagnostic efficacy of both Hysterosalpingography and Transvaginal ultrasonography compared to Hysteroscopy in diagnosis of intrauterine pathological lesions or uterine structural anomalies. Compared to Hysteroscopy as gold standard, Transvaginal ultrasonography has a sensitivity of 25%, specificity of 100%, positive predictive value of 100%, negative predictive value of 84.21% and overall accuracy of 85% ; Hysterosalpingography has sensitivity of 50%, specificity of 81.25%, positive predictive value of 40%, negative predictive value of 86.67% and overall accuracy of 75%.