In order to increase the effectiveness of hydrotubation, a plastic cannula was inserted into the fallopian tube under hysteroscopic control. Fifty women with tubal blockage confirmed by HSG were selected for treatment. Hydrotubation solution consisted of hydrocortisone (20 mg), gentamicin (160,000 IU) and procaine (80 mg) in 20 ml distilled water. Repeat HSG was performed. After three treatments, tubal patency (one or both tubes) was achieved in 20 women (40%), and seven pregnancies resulted within 1-18 months. Hysteroscopic hydrotubation may be an alternative treatment for tubal blockage.