Subject: Infertility affects approximately 10% of couples which makes it one of the more common problems for which people seek medical advice.Uterine pathologies are detected in 15% of couples seeking treatment and are diagnosed in as many as 50% of infertile patients. Uterine factors of infertility include uterine congenital malformations, endometrial polyp, and sub mucous fibroid and intrauterine synechia. Several studies have demonstrated that once the uterine cavity has to be investigated as part of the infertility workup; hysteroscopy is much more accurate than other diagnostic methods, mainly SHG and HSG. Patients and methods: Sixty patients were included, all presented with infertility with suspected uterine cavity lesions in HSG. underwent saline infusion sonohysterography comparing the results with that of hysteroscopy considering it the gold standard procedure in diagnosing uterine lesion. Results: All patients included in the study underwent 2D sonohysterography with 40 (63.7%) positive patients and 20 (33.3%)negative patients. All these lesions detected by SHG confirmed by hysteroscopy except 2 cases who their sonohysterography were showing polyps while their hysteroscopy were free with concordance of 95% between the results of SHG and hysteroscopy. The sonohysterography had a sensitivity of 100%, specificity of 90%, PPV of 95% and NPV of 100%. Conclusion: SHG has greater sensitivity, positive predictive value, and accuracy than HSG has for detecting intrauterine lesions. Although HSG will continue to be an important screening tool in infertility for its proven ability to evaluate the architecture and patency of the fallopian tubes, SHG is a more reliable diagnostic tool for the evaluation of intrauterine defects.