Uterine anomalies are a relatively common congenital abnormality, which is most commonly seen while evaluating patients for infertility as well as for recurrent pregnancy loss especially in 1st and 2nd trimester. Septum is of different types i.e. partial septum, complete septum, cervical septum, and vaginal septum. Uterine septum is especially known to cause recurrent pregnancy loss in 40–60% of women. Hysteroscopic metroplasty is currently considered, the gold standard for septal anomalies. But before we start we must do preoperative evaluation to rule out other causes of recurrent pregnancy loss. A detailed discussion on the surgical technique of hysteroscopic metroplasty has been presented in this chapter along with postoperative management, follow-up, and some important points.