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Background: Hysterosalpingography (HSG) is the radiographic technique for evaluation of uterine cavity and fallopian tubes. It still remains the best imaging procedure for fallopian tubes despite the advent of newer modalities and is used primarily for the evaluation of female infertility.1,2 The purpose of the study was to assess the uterine and tubal abnormalities detected on radiographic HSG as causative factors of infertility and to describe their imaging features. Methods: This prospective cross sectional study was conducted at the Department of Radiodiagnosis and Imaging, BPKIHS, Dharan. Forty-four patients with infertility (both primary and secondary) referred for HSG were included. HSG was performed using non-ionic contrast medium under image intensifier fluoroscopic control during the follicular phase of menstrual cycle. Radiographic films were obtained and analyzed. Results: Out of the total 44 patient, 26 (59.0%) had primary infertility while 18 (41.0%) had secondary infertility. Tubal abnormalities were seen in 28 (63.6%) and uterine abnormalities in 2 (4.6%) patients. The most common tubal abnormality detected on HSG was tubal block (50.0%). Unilateral and bilateral tubal blocks were equally distributed (50.0% each). Proximal tubal block was observed in 8 (36.4%) and distal in 13 (59.1%) patients. Fifteen (34.1%) patients had hydrosalpinx. Conclusion: HSG is easy, safe, and cost-effective and plays vital role in the evaluation of female with infertility. The most common structural cause of female infertility found as per this study was tubal block. Nepalese Journal of Radiology / Vol.3 / No.1 / Issue 4 / Jan-June, 2013 / 59-66 DOI: http://dx.doi.org/10.3126/njr.v3i1.8810