Only in the last few years have gynecologists begun to investigate the use of microsurgical technics. Investigators in Europe, Canada, and the United States have recently reported improvements in patency and intrauterine pregnancy rates using these meticulous technics. At Vanderbilt University Medical Center, gynecologic microsurgery has been applied for the last two years, and this report reviews our experience in 24 patients undergoing reversal of a previous sterilization. Preoperative counseling and evaluation of patients considering surgery are discussed. Technical points regarding choice of instruments, intraoperative technics, and ancillary therapy, such as steroids, postoperative hydrotubation, and the use of intraperitoneal dextran, are reviewed. The results are presented and compared with reports using conventional surgical technics for reversal of female sterilization.