Abstract In India, 5 to 18 % of females attending infertility clinics are diagnosed to be suffering fromgenital tuberculosis. The present study was conducted to find out the prevalence of endometrial tuberculosis in infertility and its correlation with hysteroscopic changes. Patients attending infertility clinic with history of more than 2 years of unexplained infertility, failure to conceive in spite of successful ovulation induction in anovulatory infertility, and secondary infertility with a history of unexplained abortion or ectopic pregnancy were included in the study. In all the 105 cases, hysteroscopy was done, and the endometrium was subjected to DNA-PCR (polymerase
chain reaction) testing for detection of Mycobacterium tuberculosis infection. Hysteroscopy features were compared in tuberculosis positive (39 %) and negative (61 %) cases for correlation. Tuberculosis was detected in 43.75 % of ostial and periostial fibrosis, 48.48 % of intrauterine fibrosis, and 66.67 % of the irregular cavity surface. A complete 6-month course of antitubercular treatment was given to the tuberculo-sis positive cases among which 39 % conceived without any additional treatment. The pregnancy rate of 64.7% in second-ary infertility and 20.8% in primary infertility was verymuch promising. Tuberculosis is one of the major etiological factors in female infertility in developing countries. Preliminary as-sessment by hysteroscopy followed by PCR testing for Mycobacterium tuberculosiswill detect it early. Subsequent antitubercular treatment may reverse the reproductive capa-bility and prevent permanent damage to the female reproduc-tive organs.