A comparative study of hysterosalpingography (HSG) and laparoscopy in the Investigation of infertility is presented. Laparoscopy with permeability testing was performed in 68 patients previously investigated by HSG. Complete history of factors that may predispose to tubal occlusion was obtained. Patients with problems of ovulatory failure or poor semen analysis that may contribute to their infertility were excluded. There was agreement between the two techniques in 19 (27.9%) of cases where both tubes were patent i.e. all the cases that identified to be patent in HSG, were patent in laparoscopy. Similarly, agreement between the two techniques in terms of bilateral blockage (26.4%), right tubal blockage in only (5.8%), and the left tubal blockage, there was (4.4%) agreement between two techniques. The overall agreement between the two methods was (64.5%) of cases. However, the diagnostic accuracy of the two methods differed significantly. It would appear that laparoscopic hydrotubation, despite its invasive nature has an edge in diagnostic accuracy when compared with HSG. It would be advantageous to subject patients in whom HSG has shown tubal blockage to laparoscopy or any of the newer techniques of hysteroscopy or sonographic hydrotubation