Congenital uterine anomalies (CUAs) are present in up to 10% of all women. Data suggest that women with CUAs are at higher risk of recurrent spontaneous abortions and adverse pregnancy outcomes. It is still debated whether these women have impaired fertility. The complication rate is likely to be overrepresented and assumedly many women with CUAs have normal reproduction and uneventful pregnancies. In women with CUAs and infertility or numerous spontaneous abortions surgical treatment should be considered.