Tubal disease constitutes a major factor in infertility especially in developing countries. This study was undertaken to assess the hysterosalpingographic patterns seen in infertile patients in an urban centre in Lagos. Two hundred and twenty patients who reported from the gynaecology clinic to the radiology department of Lagos State University Teaching Hospital were subjected to hysterosalpingography, and the results were analyzed for tubal pathology as revealed on radiographs. One hundred and eighty five (84%) patients had secondary infertility while 35(16%) had primary infertility. The commonest pathology found on hysterosalpingography in patients presenting with infertility in this study was tubal blockage, whether unilateral or bilateral, followed by hydrosalpinx of one or both fallopian tubes. Eighty four (38.2%) patients had both fallopian tubes opacified and were classified as normal, while in 22(10%), both tubes were not seen. Of the opacified abnormal fallopian tubes, bilateral hydrosalpinx was diagnosed in 6 patients (2.7%), while right and left sided hydrosalpinx were seen in 6(2.7%) and 8(3.6%) patients respectively. There was evidence of loculated peritoneal contrast spills from 10(4.5%) on each of the sides and from both tubes in 2(1%) patients. The high prevalence of tubal pathology was demonstrated in this study but the contribution of hydrosalpinx is much less than findings from other centres in the sub region. (Contains 1 table and 4 figures.)