Prolactin is an important hormone for maintenance of normal sexual life in human. Prolactin is produced in the lactotropic cells in the lateral wing of the anterior pituitary gland. Prolactin imbalance associated with bilharzial hepatosplenomegaly with subsequent infertility was carried out on sixty female patients and 30 normal controls. In bilharzial patients and 30 normal controls. In bilharzial patients with hepatosplenomegaly, there was hyperprolactinaemia in 13.33% of cases. 10% of patients suffering from bilharzial hepatosplenomegaly had primary infertility and 70% had secondary infertility more than 5 years. Galactorrhea was present in 10% of cases with bilharzial hepatosplenomegaly. There was irreversible relationship between the duration of bilharzial infection and serum prolactin level and inability to conceive, and also between the duration of bilharzial infection and endocrine manifestations as infrequency and irregularity of menstruation.