A case which reaffirms the suspicion that tubal cauterization preceded by IUD removal and subsequent curettage can lead to adnexitis and pelvic abscess is presented. A 35-year-old white woman was admitted to a hospital emergency room with the acute onset of right adnexal pain. Her last normal menstrual period had started 5 days before her admission. She had been wearing an IUD for 5 years and because of progressively increasing menorrhagia and dysmenorrhea her request that the IUD be removed was granted. The patients pain improved and since she expressed interest in a sterilization procedure she was subjected to examination under anesthesia curettage and laparoscopy for both the determination of the etiology of the adnexal pain and the tubal cauterization. At the time of laparoscopy the right ovary appeared to have a ruptured cyst in its distal pole. Uneventful bilateral tubal cauterization and division were carried out. Histologic examination of the curettings was done and the patient was discharged on Postoperative Day 1 with the diagnosis of a ruptured functional right ovarian cyst. She was readmitted 17 days after laparoscopy with right adnexal pain and fever. Examination revealed an 8 cm right tuboovarian abscess. Total abdominal hysterectomy bilateral salpingo-oophorectomy and appendectomy were carried out. (The appendix was involved in the abscess formation.) After experience with this case it is the authors policy to remove IUDs 1 menstrual interval prior to anticipated laparoscopic tubal cauterization. When this is not possible the patient is given prophylactic antibiotics during the procedure and in the immediate postoperative period.