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The aim of this work was to assess the state of the fallopian tubes in women with urogenital chlamydia (UC) and infertility. 344 women 18-49 y.o with infertility have been investigated. UC was detected in 133 of them -38.7%, (main group), UC was absent in 211 (61.3%) patients (comparision group). In the main group prevailed the tubal or tubal peritoneal factor of infertility (51.9% versus 19.4% in the comparison group, p<0.001). UC in women in the main (62.4%) was in the form of mixed infection. Obstruction of the fallopian tubes and adhesions in the pelvic region were more often detected in patients of the main group (p<0.05). The most pronounced lesions of the fallopian tubes were observed in women with chlamydial mixed infection. Adhesive process in the small pelvis was established by laparascopy in 72.2% of women in the main group and in 27.8% in the comparison group (p<0.001). There was a correlation between the extent of the adhesion process in the small pelvis and the presence of chlamydial mixed infection. A histological study was carried out of the tissues of the fallopian tubes in 12 women diagnosed with an ectopic pregnancy, 5 of whom had UC. Women with UC have alternating areas with signs of acute inflammation and various stages of the reparative processand in 4 women with UC the above mentioned signs and sclerosis were detected also in the the submucosa, which can cause destruction of the functional activities of the fallopian tubes and obstruction as well. All this causes a violation of the transport of spermatozoa, the embryo and leads to a ectopic pregnancy and infertility. Obtained results explain the inefficiency of restoring reproductive function in women after elimination of UC with preserved patency of the fallopian tubes.