Hydrosalpinx is a chronic pathologic condition of the fallopian tube, and is a major cause of infertility. In most patients, the fimbriated end of the tube adjacent to the ovary is occluded and the distal half of the tube is distended with fluid. The occlusion usually occurs secondary to pelvic inflammatory disease, and may sometimes result from fimbrial serosal obstruction following an adjacent appendicular inflammation. Distal occlusion may be the result of endometriosis.The diagnosis of hydrosalpinx is usually made by hysterosalpingography, showing a distended tube with obstructed fimbria. Sonohysterosalpingography is useful in the diagnosis of hydrosalpinx It is not usually difficult to diagnose a hydrosalpinx by vaginal ultrasound (US). However, it seems that less than half of hydrosalpinges are large enough to be noticed by vaginal US. In (1994) Atri et al. were able to diagnose hydrosalpinx by ultrasound in only 34% of patients diagnosed by hysterosalpingography.In general, surgical treatment of hydrosalpinx has a poor prognosis; however, well-selected cases with a healthy endosalpinx and Fallopian tubes with a small diameter have a good prognosis when the treatment is performed by experienced hands. The majority of patients with hydrosalpinges are usually treated by IVF. Recent evidence strongly suggests that the presence of hydrosalpinx may have a deleterious effect on pregnancy rates in IVF.