This chapter provides detail description of hydrosalpinx and distal tubal surgery. Hysterosalpingography, laparoscopy, salpingoscopy, classification of tubal and adhesion scoring, contraindications for distal tube surgery for tubal subfertility, laparoscopic management of distal tube disease, salpingo-ovariolysis, fimbrioplasty, salpingostomy, fallopian tube recanalization, role of salpingectomy, ovarian function after distal tube surgery, proximal ligation and salpingostomy, transvaginal aspiration of the tubal fluid are given in detail. 2 tables are included to highlight laparoscopic management of distal tubal diseases and comparison of pregnancy rates after IVF in patients with or without hydrosalpinges. 30 references are included at the end of the chapter to facilitate further reading.