This chapter provides detail description of Hysteroscopic tubal sterilization Essure system. Chapter has 16 well illustrated diagrams and pictures. Essure device, application, expulsion of device through vagina, migration of device, experience, results of multicentric studies, Essure related pregnancy factors, about IUD, menorrhagia, comparative economic study with laparoscopic sterilization, magnetic resonance are described in detail. 10 tables are included to highlight experience of cases in regards to insertion, pain, use of anaesthesia, adverse events, outcome both in multicentre and single centre. 40 references are included at the end of the chapter to facilitate further reading.