Pelvic adhesive disease has been implicated in the causation of as many as 15% to 20 % of cases of infertility. The role of adhesions in infertility depends on the cause, extent, and thickness of the adhesions and the structures involved. Presumably, fertility is impaired by adhesions that interfere with gamete transport or with ovum pick up secondary to altered spatial relation between the tube and ovary. A healthy reproductive tract is suspended by ligaments and it enjoys relative mobility especially at the level of the ovaries and the Fallopian tubes. However, different factors such as previous surgical interventions, infection, and inflammatory processes such as endometriosis, can induce adhesion formation. The adhesions restrict the mobility that these organs normally have. This makes it more difficult for the fimbria to trap the oocyte at the time of ovulation. It may also prevent release of the oocyte or transport of sperm. Therefore, gamete transport and fertilization are compromised. Perhaps the most difficult management of adhesions is the prevention of adhesion formation after surgery intended to eliminate them. Diagnosis and treatment can be performed using laparoscopy.