Hysteroscopy is a mainstay of modern gynaecologic practice. However, the role of ambulatory hysteroscopy and associated procedures has increased dramatically in recent years. The outpatient setting has associated benefits, both for the patient and economically. The advent of less invasive vaginoscopic techniques means that diagnostic hysteroscopy is achievable safely, comfortably and efficiently in almost all women and avoids the risk of a general anaesthetic. This review aims to summarise first the role for ambulatory hysteroscopy in diagnosis of conditions contributing to reproductive failure. The second section of the review concentrates on the therapeutic interventions that can be performed hysteroscopically in the ambulatory setting such as tubal catheterisation, tubal occlusion and uteroplasty. Lastly, we discuss the role outpatient hysteroscopy plays in established contraceptive techniques such as intrauterine device placement, and the more recent advent of hysteroscopic sterilisation.