Vaginal sonographic hydrotubation (SHT) was assessed in the evaluation of uterine configuration and tubal patency in 71 women undergoing investigation for infertility. In addition, a new technique using "agitated" saline during transvaginal sonography was evaluated in 50 of the patients. Ultrasound was more sensitive in detecting uterine abnormalities (89% compared with 6% for hysterosalpingography (HSG). Of 142 individual fallopian tubes studied, the diagnosis on SHT and HSG were the same in 120 (85%). Laparoscopic results were available on 15 patients. The findings on all 19 tubes in which the SHT and HSG diagnosis had concurred were confirmed. Of 11 tubes in which the diagnoses had differed, the laparoscopic finding agreed with the diagnosis made with SHT in seven, HSG in three, and neither in one. As shown in previous studies, sonographic hydrotubation is a simple technique with a high degree of accuracy. The use of "agitated" saline improved the ease with which the fallopian tubes were visualized.