Background: Surgical repair with resection of the septum hysteroscopically, or hysteroscopic metroplasty, provides excellent post-treatment results with significant improvement in pregnancy rates post-procedure. Aim: To define the effectiveness of therapeutic intervention through operative hysteroscopic intrauterine septum resection in increasing pregnancy rate and reducing patients’ complaints in women with primary infertility, history of preterm labor, or recurrent miscarriage. Patients & methods: This descriptive case series study was conducted on 23 female patients of reproductive age with primary infertility, a history of preterm labor or recurrent miscarriage who underwent operative hysteroscopic resection of intrauterine septa Results: The reproductive outcome in all patients shows that 16 women (69.6% of total participants) had pregnancy. No pregnancy occurred in 7 patients (30.4%). Of those, 3/16 patients (18.8% of whom had pregnancy) aborted, 10/16 patients (62.5% of pregnant patients) continued to term pregnancy, & 3 /13 studied cases (18.8% of pregnant) had a preterm delivery, the live birth rate was 81.3% (13/16). The best reproductive outcome occurred in the miscarriage group, in which the pregnancy rate & live birth rate were (75%) & (93.4%) respectively, followed by the primary infertile group (70%) and (86%). History of preterm labor group came in the last with (60%) pregnancy rate and (67%) live birth rate. Conclusion: Correction of intrauterine septum, even if a small incomplete type, improves the chance of conception in infertile women who have no other causes for infertility and increases the live birth rate with a decrease in miscarriage rate.