Summary Thirty-six patients with a diagnosis of bilateral tubal occlusion on hysterosalpingography subsequently underwent laparoscopy and injection of dye through the cervix into the uterus. Bilateral tubal patency was demonstrated in 11 patients (31 per cent) and unilateral patency in 7 more (19 per cent). In view of the poor results from tubal plastic procedures it is advocated that laparoscopy be carried out before tubal surgery on all patients with bilateral negative salpingograms, especially to cases with apparent occlusion at the fimbria.