To describe a successful pregnancy and delivery after calcium ionophore oocyte activation in a normozoospermic patient with previous repeated failed fertilization after intracytoplasmic sperm injection (ICSI).Case report. In vitro fertilization unit in a university affiliated medical center.A couple with 5 years of unexplained primary infertility who had repeated failed fertilization after ICSI. Controlled ovarian hyperstimulation, oocyte pick-up, ICSI, assisted oocyte activation with calcium ionophore, embryo culture, and ET. Fertilization rate, implantation, pregnancy, and delivery. Assisted oocyte activation with calcium ionophore A23187 after ICSI resulted in reasonable fertilization rates in three cycles (4/6, 5/16 and 7/20 oocytes). Two pregnancies were achieved; the first ended with second trimester miscarriage due to fetal anomaly and the second with a delivery of three healthy babies.Calcium ionophore oocyte activation seems to be a useful method in cases of repeated failed fertilization after ICSI.