Pelvic adhesions are fibrotic tissue or scars that develop in the pelvic cavity between the uterus, ovaries, tubes, bowels and bladder also. They can be found inside the tubes and uterus. The adhesions can block or distort the anatomy of the tubes. It is responsible for 15–20% of all infertility causes. Tubal infertility accounts for 30–40% of female infertility. Pelvic adhesions usually result after abdominal and pelvic surgeries resulting in chronic pelvic pain, intestinal obstruction, and infertility. This chapter covers the incidence of postoperative adhesions, pathophysiology of adhesion development, type of adhesions, risk factors in the formation of pelvic adhesions, cause of pelvic adhesions and tubal lesions, mechanism resulting in infertility, methods to diagnose tubal blockage, surgery or assisted reproductive technique, choice of techniques for adhesiolysis, adjuvants for adhesions reduction, and significance of good surgical technique.