Objective: To compare the efficacy of fallopian tube sperm perfusion using 4 ml sperm suspension, standard intrauterine insemination and timed intercourse after controlled ovarian hyperstimulation in management of unexplained infertility. Design: Prospective randomized trial. Setting: Outpatient clinic of the Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University. Patients: 90 infertile women less than 40 years old with unexplained infertility of 3 years or more were included in this study. Intervention: All patients underwent controlled ovarian hyperstimulation using clomiphene citrate and/or HMG, 30-36 hours after HCG, the patients were randomly assigned to receive either fallopian tube sperm perfusion (FSP) using Pediatric Foley's catheter (group I - 30 patients) standard intrauterine insemination IUI (group II - 30 patients) or timed intercourse (group III - 30 patients). Main outcome measures: Feasibility of FSP using pediatric Foley's catheter and pregnancy rate in each group. Results: The fallopian sperm perfusion using pediatric Foley's catheter was simple, easy to perform and tolerable by patients. The overall pregnancy rate was slightly higher (26.7%) in FSP group than IUI group (23.3%). The pregnancy rates were significantly higher in FSP and IUI groups than timed intercourse group (10%). Conclusion: Fallopian sperm perfusion using pediatric Foley's catheter is a simple, reliable method and may lead to a slightly better pregnancy rate than standard IUI in cases of unexplained infertility.